Evidence map›Paper›PMID 36464694›Full record

ArticleBMC pregnancy and childbirth2022

A new modified obstetric early warning score for prognostication of severe maternal morbidity.

Yonghui Xu, Sha Zhu, Hao Song, Xiaoyuan Lian, Maoni Zeng, Ji He, Lijuan Shu, XingSheng Xue, Fei Xiao

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PubMed Full text at PMC Publisher
In one paragraph

Article in BMC pregnancy and childbirth, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.

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0cells of the map it votes in
7citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

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3 · Its place in the literature

Who cites it

7 citing papers in PubMed.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Yonghui XuDepartment of Obstetrics and Gynecology Intensive Care Unit, West China Women's and Children's Hospital, Sichuan University, No. 20, Section 3, Renmin South Road, Chengdu, China.
Sha ZhuDepartment of Obstetrics and Gynecology Intensive Care Unit, West China Women's and Children's Hospital, Sichuan University, No. 20, Section 3, Renmin South Road, Chengdu, China.
Hao SongDepartment of Obstetrics and Gynecology Intensive Care Unit, West China Women's and Children's Hospital, Sichuan University, No. 20, Section 3, Renmin South Road, Chengdu, China.
Xiaoyuan LianDepartment of Obstetrics and Gynecology Intensive Care Unit, West China Women's and Children's Hospital, Sichuan University, No. 20, Section 3, Renmin South Road, Chengdu, China.
Maoni ZengDepartment of Obstetrics and Gynecology Intensive Care Unit, West China Women's and Children's Hospital, Sichuan University, No. 20, Section 3, Renmin South Road, Chengdu, China.
Ji HeDepartment of Obstetrics and Gynecology Intensive Care Unit, West China Women's and Children's Hospital, Sichuan University, No. 20, Section 3, Renmin South Road, Chengdu, China.
Lijuan ShuDepartment of Obstetrics and Gynecology Intensive Care Unit, West China Women's and Children's Hospital, Sichuan University, No. 20, Section 3, Renmin South Road, Chengdu, China.
XingSheng XueDepartment of Obstetrics and Gynecology Intensive Care Unit, West China Women's and Children's Hospital, Sichuan University, No. 20, Section 3, Renmin South Road, Chengdu, China.
Fei XiaoDepartment of Obstetrics and Gynecology Intensive Care Unit, West China Women's and Children's Hospital, Sichuan University, No. 20, Section 3, Renmin South Road, Chengdu, China. Xiaofei2021cd@163.com.ORCID http://orcid.org/0000-0002-6367-7268

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundMaternal mortality is still a major challenge for health systems, while severe maternal complications are the primary causes of maternal death. Our study aimed to determine whether severe maternal morbidity is effectively predicted by a newly proposed Modified Obstetric Early Warning Score (MOEWS) in the setting of an obstetric intensive care unit (ICU).

methodsA retrospective study of pregnant women admitted in the ICU from August 2019 to August 2020 was conducted. MOEWS was calculated 24 h before and 24 h after admission in the ICU, and the highest score was taken as the final value. For women directly admitted from the emergency department, the worst value before admission was collected. The aggregate performance of MOEWS in predicting critical illness in pregnant women was evaluated and finally compared with that of the Acute Physiology and Chronic Health Evaluation II (APACHE II) score.

resultsA total of 352 pregnant women were enrolled; 290 women (82.4%) with severe maternal morbidity were identified and two of them died (0.6%). The MOEWSs of women with serious obstetric complications were significantly higher than those of women without serious obstetric complications [8(6, 10) vs. 4(2, 4.25), z = -10.347, P < 0.001]. MOEWSs of 24 h after ICU admission had higher sensitivity, specificity and AUROC than MOEWSs of 24 h before ICU admission. When combining the two MOEWSs, sensitivity of MOEWS was 99.3% (95% CI: 98-100), specificity 75.8% (95% CI: 63-86), positive predictive value (PPV) 95.1% (95% CI: 92-97) and negative predictive value (NPV) 95.9% (95% CI: 86-100). The areas under the receiver operator characteristic (ROC) curves of MOEWS were 0.92 (95% CI: 0.88-0.96) and 0.70 (95% CI: 0.63-0.76) of the APACHE II score.

conclusionThe newly proposed MOEWS has an excellent ability to identify critically ill women early and is more effective than APACHE II. It will be a valuable tool for discriminating severe maternal morbidity and ultimately improve maternal health.

Indexed as

Early Warning ScoreMaternal DeathFemaleHospitalizationHumansIntensive Care UnitsPregnancyRetrospective StudiesAPACHE II scoreIntensive care unit (ICU)Maternal morbidityMaternal mortalityModified obstetric early warning score (MOEWS)

Identifiers

PMID36464694
PMCPMC9720996

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.