Prediction Tests for Recurrent Hypertensive Disease in Pregnancy, A Systematic Review

Objective. To summarize reported evidence on the performance and clinical usefulness of prediction tests for recurrent hypertensive disease in pregnancy. Methods. A literature search was conducted in MEDLINE/PubMed and EMBASE. Test characteristics were extracted for relevant reports. Results. Thirty-three of 4,311 articles found met the inclusion criteria. Twenty-four potential predictors were identified. Pre-pregnant plasma volume, uterine-artery blood flow velocity profiles, and combined longitudinal patterns of in-pregnancy laboratory variables had reasonable predictive capacity, but also some practical shortcomings. Confidence intervals were often wide. Conclusions. Although evidence points to promising predictive accuracy of some tests, immediate applicability is hampered by statistical imprecision and clinical drawbacks.