{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T22:49:24Z","timestamp":1790894964146,"version":"4.1.0"},"reference-count":24,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2026,4,2]],"date-time":"2026-04-02T00:00:00Z","timestamp":1775088000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,4,2]],"date-time":"2026-04-02T00:00:00Z","timestamp":1775088000000},"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":[[2026,10]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>The objective of this study is to validate the fullPIERS (Pre\u2010eclampsia Integrated Estimate of Risk) prognostic model in a large, multicenter cohort of Brazilian women with preeclampsia and to determine the optimal cutoff for clinical application in the Brazilian context.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This was a secondary analysis of five prospective Brazilian studies evaluating the fullPIERS model, conducted in tertiary obstetric referral centers across three geographic regions (Porto Alegre, Campinas, Recife, Belo Horizonte, and Joinville). A total of 1581 pregnant women with confirmed preeclampsia were included. The primary outcome was the occurrence of one or more severe maternal complications within 48\u2009h of assessment. FullPIERS risk estimates were calculated using routinely collected clinical and laboratory variables. Model performance was assessed by receiver operating characteristic (ROC) curve analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Severe maternal complications occurred in 235 women (14.86%), with HELLP (hemolysis, elevated liver enzymes and low platelets) syndrome being the most frequent (9.5%). The fullPIERS model demonstrated moderate discriminative ability, with an area under the ROC curve of 0.753 (95% confidence interval: 0.714\u20130.791). The optimal cutoff value of 2.35% yielded a sensitivity of 58.3%, specificity of 84.6%, and a negative predictive value (NPV) of 94.8%.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>In this large, geographically diverse Brazilian cohort, the fullPIERS model showed substantial clinical utility for ruling out severe maternal complications in women with preeclampsia. Its high NPV supports its use in referral decision\u2010making and prioritization of resources. Given its reliance on routinely available clinical data, fullPIERS might serve as a valuable tool to optimize maternal care pathways, particularly in resource\u2010limited settings.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ijgo.70989","type":"journal-article","created":{"date-parts":[[2026,4,2]],"date-time":"2026-04-02T07:17:05Z","timestamp":1775114225000},"page":"174-181","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Validation of the\n                    <scp>fullPIERS<\/scp>\n                    model for predicting severe maternal outcomes in preeclampsia in five Brazilian centers"],"prefix":"10.1002","volume":"175","author":[{"given":"Pedro do Valle","family":"Teichmann","sequence":"first","affiliation":[{"name":"Federal University of Rio Grande do Sul  Porto Alegre Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3648-6159","authenticated-orcid":false,"given":"Jos\u00e9 Paulo Siqueira","family":"Guida","sequence":"additional","affiliation":[{"name":"University of Campinas  Campinas Brazil"},{"name":"Brazilian Network for Studies in Hypertension in Pregnancy  Botucatu Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria Laura","family":"Costa","sequence":"additional","affiliation":[{"name":"University of Campinas  Campinas Brazil"},{"name":"Brazilian Network for Studies in Hypertension in Pregnancy  Botucatu Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leila","family":"Katz","sequence":"additional","affiliation":[{"name":"Instituto de Medicina Integral Prof. Fernando Figueira (IMIP)  Recife Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Melania Maria","family":"Amorim","sequence":"additional","affiliation":[{"name":"Instituto de Medicina Integral Prof. Fernando Figueira (IMIP)  Recife Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jussara","family":"Mayrink","sequence":"additional","affiliation":[{"name":"Federal University of Minas Gerais  Belo Horizonte Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giorgio","family":"Tondello","sequence":"additional","affiliation":[{"name":"University of Campinas  Campinas Brazil"},{"name":"Brazilian Network for Studies in Hypertension in Pregnancy  Botucatu Brazil"},{"name":"Darcy Vargas Maternity  Joinville Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sergio Hofmeister de Almeida Martins","family":"Costa","sequence":"additional","affiliation":[{"name":"Federal University of Rio Grande do Sul  Porto Alegre Brazil"},{"name":"Brazilian Network for Studies in Hypertension in Pregnancy  Botucatu Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jos\u00e9 Geraldo","family":"Lopes Ramos","sequence":"additional","affiliation":[{"name":"Federal University of Rio Grande do Sul  Porto Alegre Brazil"},{"name":"Brazilian Network for Studies in Hypertension in Pregnancy  Botucatu 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