{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T14:37:28Z","timestamp":1777905448701,"version":"3.51.4"},"reference-count":48,"publisher":"MDPI AG","issue":"1","license":[{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Diagnostics"],"abstract":"<jats:p>Background\/Objectives: In low-resource settings, diagnostic delays and limited specialist access worsen health inequalities, making hypertensive disorders of pregnancy (HDPs) defined by new-onset blood pressure \u2265 140\/90 mmHg after 20 weeks of gestation, with or without proteinuria, a major cause of maternal morbidity and mortality. This study evaluated the diagnostic effectiveness of a rural-applicable clinical model for detecting HDPs in a real-world population from Hospital General San Felipe (Tegucigalpa, Honduras). Methods: A cross-sectional diagnostic accuracy study was conducted on 147 consecutive pregnant women in February 2025. Clinical documentation from the initial appointment defined HDP. We modeled HDP risk using penalized logistic regression and common factors such maternal age, gestational age, blood pressure, BMI, primary symptoms, semi-quantitative proteinuria, and medical history. Median imputation was utilized for missing numbers and stratified five-fold cross-validation assessed performance. We assessed AUROC, AUPRC, Brier score, calibration, and operational utility at a data-driven threshold. Results: Of patients, 27.9% (41\/147) had HDP. The model had an AUROC of 0.614, AUPRC of 0.461 (cross-validation averages), and Brier score of 0.253. The threshold with the highest F1-score (0.474) had a sensitivity of 0.561, specificity of 0.679, positive predictive value of 0.404, and negative predictive value of 0.800. HDP had higher meaning systolic\/diastolic\/mean arterial pressure (130.7\/82.9\/98.9 vs. 120.5\/76.1\/90.9 mmHg) and ordinal proteinuria (0.59 vs. 0.36 units). Conclusions: The model had moderate but clinically meaningful discriminative performance using low-cost, commonly obtained variables, excellent calibration, and a good negative predictive value for first exclusion. These findings suggest modification of predictors, a larger sample size, and clinical usefulness assessment using decision curves and process outcomes, including quick referral and prophylaxis. This approach aligns with contemporary developments in the 2023\u20132025 European Society of Cardiology (ESC) and 2024 American Heart Association (AHA) guidelines, which emphasize earlier identification and risk-stratified management of hypertensive disorders during pregnancy as a cornerstone of women\u2019s cardiovascular health.<\/jats:p>","DOI":"10.3390\/diagnostics16010132","type":"journal-article","created":{"date-parts":[[2026,1,2]],"date-time":"2026-01-02T09:18:56Z","timestamp":1767345536000},"page":"132","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Diagnostic Gap in Rural Maternal Health: Initial Validation of a Parsimonious Clinical Model for Hypertensive Disorders of Pregnancy in a Honduran Hospital"],"prefix":"10.3390","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1410-7189","authenticated-orcid":false,"given":"Isaac","family":"Zablah","sequence":"first","affiliation":[{"name":"Neurosciences Research Group, Faculty of Medical Sciences, National Autonomous University of Honduras, Tegucigalpa 11101, Honduras"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-6555-6257","authenticated-orcid":false,"given":"Carlos","family":"Agudelo-Santos","sequence":"additional","affiliation":[{"name":"Center for Biomedical Imaging Diagnostics, Research and Rehabilitation, National Autonomous University of Honduras, Tegucigalpa 11101, Honduras"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9485-2658","authenticated-orcid":false,"given":"Yolly","family":"Molina","sequence":"additional","affiliation":[{"name":"Center for Biomedical Imaging Diagnostics, Research and Rehabilitation, National Autonomous University of Honduras, Tegucigalpa 11101, Honduras"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2649-788X","authenticated-orcid":false,"given":"Marcio","family":"Madrid","sequence":"additional","affiliation":[{"name":"Department of Public Health, Faculty of Medical Sciences, National Autonomous University of Honduras, Tegucigalpa 11101, Honduras"},{"name":"Hospital General San Felipe, Ministry of Health (SESAL), Tegucigalpa 11101, Honduras"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Arnoldo","family":"Zelaya","sequence":"additional","affiliation":[{"name":"Hospital General San Felipe, Ministry of Health (SESAL), Tegucigalpa 11101, Honduras"},{"name":"Department of Gynecology and Obstetrics, Faculty of Medical Sciences, National Autonomous University of Honduras, Tegucigalpa 11101, Honduras"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4221-9989","authenticated-orcid":false,"given":"Edil","family":"Argueta","sequence":"additional","affiliation":[{"name":"Centro Medico Nacional 20 de Noviembre, Mexico City 03104, Mexico"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Salvador","family":"Diaz","sequence":"additional","affiliation":[{"name":"Neurosciences Research Group, Faculty of Medical Sciences, National Autonomous University of Honduras, Tegucigalpa 11101, Honduras"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0574-1513","authenticated-orcid":false,"given":"Antonio","family":"Garcia-Loureiro","sequence":"additional","affiliation":[{"name":"Department of Electronics and Computer Science, University Santiago de Compostela, 15706 A Coru\u00f1a, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2026,1,1]]},"reference":[{"key":"ref_1","unstructured":"World Health Organization (2023). 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