A preeclampsia risk prediction model for Chinese pregnant patients with systemic lupus erythematosus.

OBJECTIVE: To screen for a high risk of preeclampsia (PE) in women with systemic lupus erythematosus (SLE). METHODS: Five hundred thirteen antenatal care records of pregnant SLE patients were obtained and the data were randomly assigned to either a development set (n=342) or a validation set (n=171). PE predictors were identified with stepwise regression, and coefficient B of each variable was used to establish a prediction model and risk scoring system. Goodness-of-fit was assessed by the Hosmer-Lemeshow and Omnibus tests, and the area under the receiver operating characteristic curve (AUC) was used to assess discrimination. Validation was performed using the validation set. RESULTS: The PE incidence was 14.4% in the pregnant SLE patients. A mean arterial pressure (MAP) ≥96.5 mmHg (OR 213.15, 95% CI=24.39-999.99), prepregnancy hypertension (OR 18.19, 95% CI=2.67-125.01), a hematological disorder (OR 4.13, 95% CI=1.03-16.67), positive aCL-IgM (OR 19.85, 95% CI=1.11-333.33), serum albumin 4 indicated a high risk of PE. For the validation set, the PE prediction accuracy was 93.6% (sensitivity=88.5%, specificity=94.5%). CONCLUSION: A model for predicting the risk of PE in pregnant SLE patients was established on the basis of MAP, prepregnancy hypertension, hematological disorders, aCL-IgM, albumin, uric acid and 24-hour urinary protein. The model had good predictive efficiency and can help clinicians improve pregnancy outcomes in high-risk women with early interventions.