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Predicting intensive care need in women with preeclampsia using machine learning–a pilot study

Edvinsson, Camilla LU ; Björnsson, Ola LU ; Erlandsson, Lena LU and Hansson, Stefan R. LU orcid (2024) In Hypertension in Pregnancy 43(1).
Abstract

Background: Predicting severe preeclampsia with need for intensive care is challenging. To better predict high-risk pregnancies to prevent adverse outcomes such as eclampsia is still an unmet need worldwide. In this study we aimed to develop a prediction model for severe outcomes using routine biomarkers and clinical characteristics. Methods: We used machine learning models based on data from an intensive care cohort with severe preeclampsia (n=41) and a cohort of preeclampsia controls (n=40) with the objective to find patterns for severe disease not detectable with traditional logistic regression models. Results: The best model was generated by including the laboratory parameters aspartate aminotransferase (ASAT), uric acid and body... (More)

Background: Predicting severe preeclampsia with need for intensive care is challenging. To better predict high-risk pregnancies to prevent adverse outcomes such as eclampsia is still an unmet need worldwide. In this study we aimed to develop a prediction model for severe outcomes using routine biomarkers and clinical characteristics. Methods: We used machine learning models based on data from an intensive care cohort with severe preeclampsia (n=41) and a cohort of preeclampsia controls (n=40) with the objective to find patterns for severe disease not detectable with traditional logistic regression models. Results: The best model was generated by including the laboratory parameters aspartate aminotransferase (ASAT), uric acid and body mass index (BMI) with a cross-validation accuracy of 0.88 and an area under the curve (AUC) of 0.91. Our model was internally validated on a test-set where the accuracy was lower, 0.82, with an AUC of 0.85. Conclusion: The clinical routine blood parameters ASAT and uric acid as well as BMI, were the parameters most indicative of severe disease. Aspartate aminotransferase reflects liver involvement, uric acid might be involved in several steps of the pathophysiologic process of preeclampsia, and obesity is a well-known risk factor for development of both severe and non-severe preeclampsia likely involving inflammatory pathways.

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author
; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Artificial intelligence, aspartate aminotransferase, body mass index, clinical prediction model, uric acid
in
Hypertension in Pregnancy
volume
43
issue
1
article number
2312165
publisher
Taylor & Francis
external identifiers
  • pmid:38385188
  • scopus:85185484964
ISSN
1064-1955
DOI
10.1080/10641955.2024.2312165
language
English
LU publication?
yes
id
e562ba5d-0d01-428e-984b-a1c5d223cc77
date added to LUP
2024-03-20 11:27:47
date last changed
2024-04-17 10:55:49
@article{e562ba5d-0d01-428e-984b-a1c5d223cc77,
  abstract     = {{<p>Background: Predicting severe preeclampsia with need for intensive care is challenging. To better predict high-risk pregnancies to prevent adverse outcomes such as eclampsia is still an unmet need worldwide. In this study we aimed to develop a prediction model for severe outcomes using routine biomarkers and clinical characteristics. Methods: We used machine learning models based on data from an intensive care cohort with severe preeclampsia (n=41) and a cohort of preeclampsia controls (n=40) with the objective to find patterns for severe disease not detectable with traditional logistic regression models. Results: The best model was generated by including the laboratory parameters aspartate aminotransferase (ASAT), uric acid and body mass index (BMI) with a cross-validation accuracy of 0.88 and an area under the curve (AUC) of 0.91. Our model was internally validated on a test-set where the accuracy was lower, 0.82, with an AUC of 0.85. Conclusion: The clinical routine blood parameters ASAT and uric acid as well as BMI, were the parameters most indicative of severe disease. Aspartate aminotransferase reflects liver involvement, uric acid might be involved in several steps of the pathophysiologic process of preeclampsia, and obesity is a well-known risk factor for development of both severe and non-severe preeclampsia likely involving inflammatory pathways.</p>}},
  author       = {{Edvinsson, Camilla and Björnsson, Ola and Erlandsson, Lena and Hansson, Stefan R.}},
  issn         = {{1064-1955}},
  keywords     = {{Artificial intelligence; aspartate aminotransferase; body mass index; clinical prediction model; uric acid}},
  language     = {{eng}},
  number       = {{1}},
  publisher    = {{Taylor & Francis}},
  series       = {{Hypertension in Pregnancy}},
  title        = {{Predicting intensive care need in women with preeclampsia using machine learning–a pilot study}},
  url          = {{http://dx.doi.org/10.1080/10641955.2024.2312165}},
  doi          = {{10.1080/10641955.2024.2312165}},
  volume       = {{43}},
  year         = {{2024}},
}