Predictors of Obstetrical Complications: A Prospective Cohort Study

Abstract

Background: The objective was to identify predictors of obstetrical complications.

Methods: A prospective cohort study, a state-run obstetrical hospital, Omsk, Russia. Out of a total 2,497 pregnant women with a gestation age of less than 12 weeks, 2,356 women with singlet pregnancies were selected. Data at gestation outcome were available for 2,177 women. Medical and social factors were evaluated and blood coagulation screening was performed in women in the first trimester. Ordered logistic regression was used to assess risks of obstetrical complications. The following obstetrical complications were evaluated after 28 weeks of gestation: preeclampsia, abruptio placentae, preterm labor, intrauterine growth restriction and intrauterine hypoxia.

Results: A prognostic model comprised of 21 predictors (P < 0.001) with strong association (0.82) between the studied parameters and the obstetrical complications was obtained. Probability of obstetrical complications (91.1%) was associated with the following parameters in women: age, education, parity, medical history, heredity (family history) and blood coagulation profile. Increased fibrinogen concentrations and reduced thrombin clotting time in the first trimester were associated with severe obstetrical complications late in pregnancy.

Conclusions: Women with late obstetrical complications were found to have increased blood viscosity and an increase in coagulation potential early in pregnancy. The prognostic model obtained may have great significance and requires further validation.




J Clin Gynecol Obstet. 2014;3(1):14-21
doi: http://dx.doi.org/10.14740/jcgo202w