高级检索

    基于孕检指标构建低风险孕妇发生自发性早产的预测模型研究

    Study on construction of a prediction model for spontaneous preterm birth in low-risk pregnant women based on pregnancy test indicators

      摘要
    • 摘要: 目的：分析影响低风险孕妇发生自发性早产（SPB）的风险因素，并构建预测模型。方法：选取2019年2月至2022年1月在本院行规律产检的236例低风险（基本情况良好且无妊娠合并症或其他妊娠风险）孕妇，分为SPB组（孕周< 37周，n=71）和足月组（孕周≥37周，n=165）。采用单因素和多因素Logistic回归分析探究SPB发生的影响因素，并建立预测模型。采用一致性指数（CI）、受试者工作特征（ROC）曲线、校准曲线及Hosmer-Lemeshow拟合优度检验（H-L检验）评价所建立模型的预测价值。结果：经产、收缩压升高、血小板计数偏高、血小板激活因子（PAF）水平升高、宫颈长度≤2.5 cm均为低风险孕妇发生SPB的影响因素（P< 0.05）；将这些影响因素作为预测因素建立列线图模型，模型预测低风险孕妇SPB 发生风险的CI 为0.774，ROC曲线下面积（AUC）为0.774（95%CI：0.710～0.839），灵敏度为69.00%，特异度为75.80%；列线图预测SPB发生风险与实际发生风险之间基本吻合，平均绝对误差（MAE）为0.024；H-L检验显示该模型的预测值与实际观察结果之间具有良好的一致性（P> 0.05）。结论：经产、宫颈长度≤2.5 cm及收缩压、血小板计数、PAF升高均为低风险孕妇发生SPB的危险因素，基于这些因素构建的预测模型辨别度、校准度及预测性能良好，可准确预测低风险孕妇发生SPB的风险。

       

      Abstract: Objective: To analyze the risk factors of spontaneous preterm birth(SPB)in low-risk pregnant wom-en based on pregnancy examination indicators and construct a prediction model.Methods: A total of 236 low-risk pregnant women (with good basic condition and no pregnancy complications or other pregnancy risks) who received regular birth examination in the Southwest Hospital Affiliated to Youjiang Medical College for Nationali-ties from February 2019 to January 2022 were selected and divided into SPB group(gestation age< 37 weeks, n=71)and full-term group(gestation age ≥37 weeks, n=165).Univariate and multivariate Logistic regression analy-sis were used to explore the influencing factors of SPB and establish a prediction model.Consistency index(CI), receiver operating characteristic (ROC) curve, curve of calibration and Hosmer-Lemeshow goodness-of-fit test(H-L test) were used to evaluate the predictive value of the model.Results: Multiparity, elevated systolic blood pressure, high platelet count, elevated level of platelet activating factor (PAF) and cervical length ≤2.5 cm were the influencing factors of SPB in low-risk pregnant women(p< 0.05).These influencing factors were used as pre-dictors to establish a nomogram model, which predicted the risk of SPB in low-risk pregnant women with CI 0.774, area under ROC curve (AUC) 0.774 (95% CI: 0.710-0.839), sensitivity 69.00% and specificity 75.80%.The nomogram predicted SPB risk was basically consistent with the actual risk, and the mean absolute error(MAE)was 0.024; H-L test showed that the predictive value of the model was in good agreement with the actual observation results (P> 0.05).Conclusion: Multipari-ty, elevated systolic blood pressure, high platelet count, elevated PAF level and cervical length ≤2.5 cm are all risk factors affecting SPB in low-risk pregnant women.The prediction model based on these factors has good discrimination, calibration and prediction perfor-mance, which can achieve accurate and personalized prediction of SPB risk in low-risk pregnant women.

       

      • HTML全文
      • 参考文献(0)
      • 相关文章
      • 施引文献
    • 资源附件(0)

    /

    返回文章
    返回