Development and Validation of a Nomogram for Predicting the Probability of Postpartum Chronic Hypertension in Women With Hypertensive Disorders of Pregnancy: A Multicenter, Cross‐Sectional Study
ABSTRACT Women with hypertensive disorders of pregnancy (HDP) have a higher risk of developing chronic hypertension (CHT) postpartum, which can lead to increased cardiovascular events. Therefore, we aimed to develop and validate a nomogram to predict the probability of CHT in HDP women by analyzing...
Saved in:
| Main Authors: | , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Wiley
2025-07-01
|
| Series: | The Journal of Clinical Hypertension |
| Subjects: | |
| Online Access: | https://doi.org/10.1111/jch.70094 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1850067594836443136 |
|---|---|
| author | Qing Liu Minghui Gong Zhuolin Su Huiran Xu Ziwei Zhao Ying Zhang Yinong Jiang Wei Song |
| author_facet | Qing Liu Minghui Gong Zhuolin Su Huiran Xu Ziwei Zhao Ying Zhang Yinong Jiang Wei Song |
| author_sort | Qing Liu |
| collection | DOAJ |
| description | ABSTRACT Women with hypertensive disorders of pregnancy (HDP) have a higher risk of developing chronic hypertension (CHT) postpartum, which can lead to increased cardiovascular events. Therefore, we aimed to develop and validate a nomogram to predict the probability of CHT in HDP women by analyzing traditional characteristics and pregnancy‐related indices. A total of 688 HDP women who delivered at the three designated hospitals in China, during the period of January 2011 to June 2021, were randomly divided into 70% (n = 482) as the training set and the remaining 30% (n = 206) as the validation set. Predictors for CHT were extracted to establish a nomogram based on multivariate logistic analysis of the training set. The performance of the nomogram was evaluated by an internal validation. In total, 207 (30.1%) patients developed CHT after delivery. Maternal age, highest systolic blood pressure (SBP), highest diastolic blood pressure (DBP), peak alkaline phosphatase (ALP) levels, peak uric acid (UA) levels, and urine protein during pregnancy were independent predictors of the nomogram. Area under the curve (AUC) of the training set was 0.819 (95% CI: 0.778–0.860, p < 0.001) and 0.800 (95% CI: 0.739–0.862, p < 0.001) in the validation set. A good consistency between the nomogram model and standard diagnostic criteria was obtained (p > 0.05). Decision curve analysis (DCA) also showed a net benefit in the nomogram when the risk thresholds were 10%–90%. In conclusion, we developed a novel clinical nomogram to predict CHT risk in women with HDP, which was a useful and easy tool to identify high‐risk individuals and performed well on internal validation. |
| format | Article |
| id | doaj-art-e5afa106bac44ceb82f91afbee6142ab |
| institution | DOAJ |
| issn | 1524-6175 1751-7176 |
| language | English |
| publishDate | 2025-07-01 |
| publisher | Wiley |
| record_format | Article |
| series | The Journal of Clinical Hypertension |
| spelling | doaj-art-e5afa106bac44ceb82f91afbee6142ab2025-08-20T02:48:16ZengWileyThe Journal of Clinical Hypertension1524-61751751-71762025-07-01277n/an/a10.1111/jch.70094Development and Validation of a Nomogram for Predicting the Probability of Postpartum Chronic Hypertension in Women With Hypertensive Disorders of Pregnancy: A Multicenter, Cross‐Sectional StudyQing Liu0Minghui Gong1Zhuolin Su2Huiran Xu3Ziwei Zhao4Ying Zhang5Yinong Jiang6Wei Song7Department of Hypertension The First Affiliated Hospital of Dalian Medical University Dalian Liaoning ChinaDepartment of Hypertension The First Affiliated Hospital of Dalian Medical University Dalian Liaoning ChinaDepartment of Hypertension The First Affiliated Hospital of Dalian Medical University Dalian Liaoning ChinaDepartment of Hypertension The First Affiliated Hospital of Dalian Medical University Dalian Liaoning ChinaDepartment of Cardiology Hulunbuir Maternity and Infant Health Institute Hulunbuir Inner Mongolia ChinaDepartment of Hypertension The First Affiliated Hospital of Dalian Medical University Dalian Liaoning ChinaDepartment of Hypertension The First Affiliated Hospital of Dalian Medical University Dalian Liaoning ChinaDepartment of Hypertension The First Affiliated Hospital of Dalian Medical University Dalian Liaoning ChinaABSTRACT Women with hypertensive disorders of pregnancy (HDP) have a higher risk of developing chronic hypertension (CHT) postpartum, which can lead to increased cardiovascular events. Therefore, we aimed to develop and validate a nomogram to predict the probability of CHT in HDP women by analyzing traditional characteristics and pregnancy‐related indices. A total of 688 HDP women who delivered at the three designated hospitals in China, during the period of January 2011 to June 2021, were randomly divided into 70% (n = 482) as the training set and the remaining 30% (n = 206) as the validation set. Predictors for CHT were extracted to establish a nomogram based on multivariate logistic analysis of the training set. The performance of the nomogram was evaluated by an internal validation. In total, 207 (30.1%) patients developed CHT after delivery. Maternal age, highest systolic blood pressure (SBP), highest diastolic blood pressure (DBP), peak alkaline phosphatase (ALP) levels, peak uric acid (UA) levels, and urine protein during pregnancy were independent predictors of the nomogram. Area under the curve (AUC) of the training set was 0.819 (95% CI: 0.778–0.860, p < 0.001) and 0.800 (95% CI: 0.739–0.862, p < 0.001) in the validation set. A good consistency between the nomogram model and standard diagnostic criteria was obtained (p > 0.05). Decision curve analysis (DCA) also showed a net benefit in the nomogram when the risk thresholds were 10%–90%. In conclusion, we developed a novel clinical nomogram to predict CHT risk in women with HDP, which was a useful and easy tool to identify high‐risk individuals and performed well on internal validation.https://doi.org/10.1111/jch.70094chronic hypertensionhypertensive disorders of pregnancyinternal validationnomogram |
| spellingShingle | Qing Liu Minghui Gong Zhuolin Su Huiran Xu Ziwei Zhao Ying Zhang Yinong Jiang Wei Song Development and Validation of a Nomogram for Predicting the Probability of Postpartum Chronic Hypertension in Women With Hypertensive Disorders of Pregnancy: A Multicenter, Cross‐Sectional Study The Journal of Clinical Hypertension chronic hypertension hypertensive disorders of pregnancy internal validation nomogram |
| title | Development and Validation of a Nomogram for Predicting the Probability of Postpartum Chronic Hypertension in Women With Hypertensive Disorders of Pregnancy: A Multicenter, Cross‐Sectional Study |
| title_full | Development and Validation of a Nomogram for Predicting the Probability of Postpartum Chronic Hypertension in Women With Hypertensive Disorders of Pregnancy: A Multicenter, Cross‐Sectional Study |
| title_fullStr | Development and Validation of a Nomogram for Predicting the Probability of Postpartum Chronic Hypertension in Women With Hypertensive Disorders of Pregnancy: A Multicenter, Cross‐Sectional Study |
| title_full_unstemmed | Development and Validation of a Nomogram for Predicting the Probability of Postpartum Chronic Hypertension in Women With Hypertensive Disorders of Pregnancy: A Multicenter, Cross‐Sectional Study |
| title_short | Development and Validation of a Nomogram for Predicting the Probability of Postpartum Chronic Hypertension in Women With Hypertensive Disorders of Pregnancy: A Multicenter, Cross‐Sectional Study |
| title_sort | development and validation of a nomogram for predicting the probability of postpartum chronic hypertension in women with hypertensive disorders of pregnancy a multicenter cross sectional study |
| topic | chronic hypertension hypertensive disorders of pregnancy internal validation nomogram |
| url | https://doi.org/10.1111/jch.70094 |
| work_keys_str_mv | AT qingliu developmentandvalidationofanomogramforpredictingtheprobabilityofpostpartumchronichypertensioninwomenwithhypertensivedisordersofpregnancyamulticentercrosssectionalstudy AT minghuigong developmentandvalidationofanomogramforpredictingtheprobabilityofpostpartumchronichypertensioninwomenwithhypertensivedisordersofpregnancyamulticentercrosssectionalstudy AT zhuolinsu developmentandvalidationofanomogramforpredictingtheprobabilityofpostpartumchronichypertensioninwomenwithhypertensivedisordersofpregnancyamulticentercrosssectionalstudy AT huiranxu developmentandvalidationofanomogramforpredictingtheprobabilityofpostpartumchronichypertensioninwomenwithhypertensivedisordersofpregnancyamulticentercrosssectionalstudy AT ziweizhao developmentandvalidationofanomogramforpredictingtheprobabilityofpostpartumchronichypertensioninwomenwithhypertensivedisordersofpregnancyamulticentercrosssectionalstudy AT yingzhang developmentandvalidationofanomogramforpredictingtheprobabilityofpostpartumchronichypertensioninwomenwithhypertensivedisordersofpregnancyamulticentercrosssectionalstudy AT yinongjiang developmentandvalidationofanomogramforpredictingtheprobabilityofpostpartumchronichypertensioninwomenwithhypertensivedisordersofpregnancyamulticentercrosssectionalstudy AT weisong developmentandvalidationofanomogramforpredictingtheprobabilityofpostpartumchronichypertensioninwomenwithhypertensivedisordersofpregnancyamulticentercrosssectionalstudy |