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The Turkish validation of the fullPIERS model to predict adverse maternal and fetal outcomes in preeclamptic
Gokce Naz Kucukbas Ozonder1, Arzu Yavuz2, Emre Sertel3
1Perinatology Division, Obstetrics and Gynecology Department, Kocaeli City Hospital, Kocaeli, Türkiye.
Introduction:
The fullPIERS (The Preeclampsia Integrated Estimate of Risk) model was developed and used in a prospective, multicenter study to identify women with preeclampsia at risk of developing complications within 7 days. This research aimed to elucidate the fullPIERS model and conduct its Turkish validation.
Methods:
A total of 214 women with singleton pregnancies complicated by preeclampsia at or before 40 weeks of gestation were retrospectively evaluated; 170 met the inclusion criteria and were included in the study. The diagnosis of preeclampsia was established in accordance with the diagnostic criteria outlined in the American College of Obstetricians and Gynecologists (ACOG) Practice Bulletin. FullPIERS scores were calculated using the online calculator available on the University of British Columbia Faculty of Medicine website.
Results:
There were statistically significant differences in gestational age at hospital admission and gestational age at delivery between patients who experienced maternal and/or fetal adverse events and those who did not (p < 0.05). There was also a significant difference in birth weight in combined maternal-fetal adverse event group and only maternal adverse event group (p = 0.001 and p < 0.05, respectively). There were differences in systolic blood pressure, creatinine, and AST values between those who experienced adverse events in mother and baby and those who did not (p < 0.001, p < 0.001, and p = 0.011, respectively). There were differences in systolic blood pressure, creatinine, AST, platelet count, proteinuria and oxygen saturation values between those who experienced only maternal adverse events and those who did not (p < 0.05, p < 0.001, p = 0.009, p < 0.05, p < 0.05 and p < 0.016 respectively). There was a significant difference in the fullPIERS score between those who experienced maternal, fetal, or combined maternal-fetal adverse events and those who did not (p < 0.001, p = 0.002 and p < 0.001, respectively).
Discussion:
The fullPIERS model captures key pathophysiological features of severe preeclampsia and demonstrates robust risk discrimination in a Turkish cohort in maternal and/or fetal adverse events, supporting its broader application in complication risk-oriented obstetric care.
