A first-trimester mean arterial pressure cutoff >90 mmHg combined with maternal factors predicted preeclampsia with an AUC of 0.73 (95% CI 0.70-0.77).
Cohort (n=10,323)
Yes
Does a mean arterial pressure cutoff value > 90 mmHg predict the development of preeclampsia in first-trimester pregnant women?
A first-trimester mean arterial pressure cutoff > 90 mmHg offers a simple, cost-effective model for predicting preeclampsia in resource-limited settings.
Effect estimate: AUC 0.73 (95% CI 0.70-0.77)
Abstract Objective: To establish an optimal mean arterial pressure (MAP) cutoff value during the first trimester of pregnancy and evaluate the performance of a simplified screening model combining this threshold with maternal factors for preeclampsia prediction in a large Chinese cohort. Because current screening methods that rely on multiples of the median (MoM) are complex, we assessed the clinical utility and predictive accuracy of a direct, absolute MAP threshold designed for resource-limited settings. Methods: This was a prospective, multicenter cohort study conducted across multiple prenatal care centers in China from May 2021 to November 2024. A consecutive sample of 10,323 women with singleton pregnancies (11 +0 to 13 +6 gestational weeks) was enrolled. Participants were retrospectively assigned to a cutoff cohort ( n = 3613, 35%) and a validation cohort ( n = 6710, 65%) using computational partitioning. The development of preeclampsia served as the primary outcome. An optimal MAP cutoff value was identified in the first cohort, and a prediction model incorporating this threshold alongside maternal characteristics was developed and validated in the second cohort. Results: Preeclampsia occurred in 388 (3.8%) participants. The optimal first-trimester MAP cutoff value was 90 mmHg. The screening model utilizing this MAP cutoff yielded an area under the curve of 0.73 (95% confidence interval ( CI ): 0.70–0.77) for cross-validation. In internal validation, the model demonstrated a specificity of 0.71 (95% CI : 0.70–0.73) and a detection rate of 41% at a fixed false-positive rate of 10%. Conclusion: A MAP value exceeding 90 mmHg can serve as a useful predictor for preeclampsia during the first trimester among Chinese women. The proposed MAP-cutoff model offers a cost-effective and readily implementable alternative to complex MoM-based algorithms, making it particularly valuable for routine clinical practice in resource-limited settings.
Tang et al. (Fri,) conducted a cohort in Preeclampsia (n=10,323). Mean arterial pressure (MAP) cutoff > 90 mmHg was evaluated on Development of preeclampsia (AUC 0.73, 95% CI 0.70-0.77). A first-trimester mean arterial pressure cutoff >90 mmHg combined with maternal factors predicted preeclampsia with an AUC of 0.73 (95% CI 0.70-0.77).