Role of gestosis score in predicting pregnancy-induced hypertension among primigravid women

Background: Pregnancy-induced hypertension (PIH) remains an important cause of maternal and perinatal morbidity. Early identification of women at increased risk may facilitate closer antenatal surveillance and timely intervention. Objective was to evaluate the role of the gestosis score in predicting PIH among primigravid women. Methods: This prospective observational cohort study was conducted in the department of obstetrics and gynecology, Dhaka Medical College Hospital, Dhaka, Bangladesh, from January to December 2021. A total of 150 primigravid women with singleton or multiple pregnancies presenting before 20 weeks of gestation were enrolled. The gestosis score was calculated at the initial antenatal assessment using predefined maternal risk factors, and participants were categorized according to a cutoff of <3 or ≥3. Women were followed prospectively until delivery for the development of PIH. The discriminatory performance of the score was assessed using sensitivity, specificity, predictive values, diagnostic accuracy, and receiver operating characteristic (ROC) analysis. Results: PIH developed in 26 (17.3%) participants. Women with a gestosis score ≥3 had a significantly higher incidence of PIH than those with a score <3 (35.6% versus 5.5%, p<0.001). Family history of hypertension, family history of pre-eclampsia, and overweight/obesity were significantly associated with PIH. At a cutoff of ≥3, the gestosis score showed 80.8% sensitivity, 69.4% specificity, 35.6% positive predictive value, 94.5% negative predictive value, and 71.3% diagnostic accuracy. The area under the ROC curve was 0.821 (95% CI: 0.738-0.904; p<0.001). Conclusions: The gestosis score demonstrated good discriminatory performance for PIH among primigravid women and may serve as a simple tool for early risk stratification and targeted antenatal surveillance. However, external validation in larger and more diverse populations is required before its routine clinical implementation.