{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,17]],"date-time":"2026-07-17T15:08:45Z","timestamp":1784300925960,"version":"3.55.0"},"reference-count":22,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2026,2,17]],"date-time":"2026-02-17T00:00:00Z","timestamp":1771286400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,2,17]],"date-time":"2026-02-17T00:00:00Z","timestamp":1771286400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Intl J Gynecology &amp; Obste"],"published-print":{"date-parts":[[2026,8]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Using data from the PREECARDIA study, we aimed to evaluate the performance of the miniPIERS model for adverse maternal outcomes and the prognostic model for perinatal death in Bissau.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted an external validation of the two predictor models using prospectively collected data from women with preeclampsia recruited at Hospital Nacional Sim\u00e3o Mendes, in Guinea\u2010Bissau, between June 2023 and January 2025. Model performance was assessed by evaluating discrimination, calibration, and risk stratification across different probability thresholds.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>During this period, 140 preeclamptic women were recruited, of whom 50 were excluded from the analysis because they had incomplete predictor or outcome information. The miniPIERS model demonstrated poor discrimination (area under the receiver operating characteristic curve [AUROC]: 0.664, 95% confidence interval [CI]: 0.50\u20130.78) and suboptimal calibration, with Calibration\u2010in\u2010the large (CITL) =\u20090.27, slope: 0.53. The prognostic model for perinatal death showed good discrimination (AUROC: 0.854, 95% CI: 0.77\u20130.93) but marked miscalibration (CITL\u2009=\u20091.43, slope\u2009=\u20092.11). The risk stratification table indicated low sensitivity and positive predictive value across different probability thresholds for both models.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The miniPIERS model showed limited utility for risk prediction in this setting, where healthcare infrastructure and population characteristics differ from the model's development context. While the prognostic model for perinatal death showed better discrimination, its poor calibration and high baseline neonatal mortality in this setting suggest that the model's utility must be interpreted cautiously. Future research should focus on larger multicenter validation studies in similar low\u2010resource settings to optimize and adapt risk prediction tools for maternal conditions such as preeclampsia.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ijgo.70850","type":"journal-article","created":{"date-parts":[[2026,2,17]],"date-time":"2026-02-17T12:11:07Z","timestamp":1771330267000},"page":"741-748","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Validation of the\n                    <scp>miniPIERS<\/scp>\n                    model and a prognostic model for perinatal death in hypertensive pregnancy: Insights from the\n                    <scp>PREECARDIA<\/scp>\n                    study in Guinea\u2010Bissau"],"prefix":"10.1002","volume":"174","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1452-1128","authenticated-orcid":false,"given":"Ruben","family":"Tur\u00e9","sequence":"first","affiliation":[{"name":"EPIUnit ITR, Institute of Public Health of the University Porto University of Porto  Porto Portugal"},{"name":"Hospital Nacional Sim\u00e3o Mendes  Bissau Guinea\u2010Bissau"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5547-0224","authenticated-orcid":false,"given":"Albertino","family":"Damasceno","sequence":"additional","affiliation":[{"name":"EPIUnit ITR, Institute of Public Health of the University Porto University of Porto  Porto Portugal"},{"name":"Department of Public Health Sciences, Forensic Sciences and Medical Education, Faculty of Medicine University of Porto  Porto Portugal"},{"name":"Faculty of Medicine University Eduardo Mondlane  Maputo Mozambique"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1870-1430","authenticated-orcid":false,"given":"Nuno","family":"Lunet","sequence":"additional","affiliation":[{"name":"Hospital Nacional Sim\u00e3o Mendes  Bissau Guinea\u2010Bissau"},{"name":"Department of Public Health Sciences, Forensic Sciences and Medical Education, Faculty of Medicine University of Porto  Porto Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,2,17]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.7189\/jogh.11.04048"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2214-109X(24)00560-6"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1002\/9781119820260.ch49"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1155\/2011\/214365"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.3310\/hta21180"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(10)61351-7"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pmed.1001589"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.preghy.2015.08.006"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjgh-2019-001759"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1002\/ijgo.13493"},{"key":"e_1_2_10_12_1","volume-title":"Plano Nacional de Desenvolvimento Sanit\u00e1rio 2018\u20132022 (PNDS III)","author":"Minist\u00e9rio da Sa\u00fade p\u00fablica da Guin\u00e9\u2010Bissau","year":"2018"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2024-091882"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0000000000003891"},{"key":"e_1_2_10_15_1","volume-title":"Piers Model for the Prediction of Adverse Maternal and Perinatal Outcomes in Preclampsia at Kenyatta National Hospital, Nairobi, Kenya","author":"Njatha GK","year":"2019"},{"key":"e_1_2_10_16_1","doi-asserted-by":"publisher","DOI":"10.20344\/amp.11178"},{"key":"e_1_2_10_17_1","doi-asserted-by":"publisher","DOI":"10.3389\/fepid.2022.871630"},{"key":"e_1_2_10_18_1","volume-title":"A Realidade das Pu\u00e9rperas do Hospital Nacional Sim\u00e3o Mendes no Per\u00edodo de Janeiro a Fevereiro de 2021","author":"Milaco S","year":"2022"},{"key":"e_1_2_10_19_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0114843"},{"key":"e_1_2_10_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.resuscitation.2021.08.024"},{"key":"e_1_2_10_21_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjgh-2016-000209"},{"issue":"74","key":"e_1_2_10_22_1","article-title":"Optimizing maternal care for better neonatal outcomes in Africa","volume":"2","author":"Dangor Z","year":"2025","journal-title":"VeriXiv"},{"key":"e_1_2_10_23_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.329.7458.168"}],"container-title":["International Journal of Gynecology &amp; 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