探索孕中晚期胎儿体重对子痫前期孕妇早产及母婴不良结局的风险预测模型  

Exploration of a risk prediction model for premature delivery and adverse maternal and infant outcomes in preeclampsia women using fetal weight in the second and third trimester

作　　者：徐桂芳 彭思思 余瑶 Xu Guifang;Peng Sisi;Yu Yao(Pingle People's Hospital,Pingle,Jiangxi 333300,China)

机构地区：[1]乐平市人民医院,江西乐平333300

出　　处：《齐齐哈尔医学院学报》2024年第14期1322-1327,共6页Journal of Qiqihar Medical University

基　　金：景德镇市科技计划(20232SFZC058)。

摘　　要：目的探索分析孕中晚期胎儿体重对子痫前期孕妇早产及母婴不良结局的风险因素,并以此构建风险预测模型。方法选择2020年1月—2023年8月本院收治的160例单胎子痫前期孕妇作为研究对象,于孕妇孕24+0至32+0周对胎儿体重进行估算,按胎儿胎龄以及预测体重的孕妇分为小于胎龄儿(SGA)组、适于胎龄儿(AGA)组和大于胎龄儿(LGA)组三组,SGA组66例AGA组75例LGA组19例。收集孕妇的一般资料,所有孕妇均追踪至分娩后1个月,观察比较三组孕妇早产情况、分娩方式、分娩孕周等发生情况,并根据早产及母婴不良结局是否发生分为发生组和未发生组,采用多因素Logistic回归分析建立风险预测模型预测相关风险因素。结果三组孕妇发生早产人数比较,差异有统计学意义(P<0.05);SGA组孕妇分娩孕周显著小于AGA组、LGA组,且AGA组孕妇分娩孕周显著小于LGA组,差异有统计学意义(P<0.05);三组孕妇自然分娩、剖腹产、人工诱导分娩方式比较,差异有统计学意义(P<0.05);三组孕妇母婴感染、宫内窘迫、其他分娩并发症比较,差异有统计学意义(P<0.05);三组孕妇产后新生儿性别、围产儿结局比较,差异无统计学意义(P>0.05);SGA组新生儿体重显著轻于AGA、LGA组,且AGA组新生儿体重显著轻于LGA组,差异有统计学意义(P<0.05);三组新生儿ICU入住率比较,差异有统计学意义(P<0.05);多因素结果显示,患者资料中孕前BMI(低体重、超重或肥胖)、产次(初产妇)、不良孕产史、孕晚中期胎儿体重(SGA)、吸烟或被动吸烟及合并妊娠高血压等为影响子痫前期孕妇发生早产及母婴不良结局的独立危险因素(P<0.05);模型以Hosmer Lemeshow检验:χ^(2)=11.252,P=0.188>0.05,即拟合度优。ROC曲线AUC为0.892(95%CI:0.826~0.958),灵敏度为78.8%,特异度为92.9%,最大约登指数为0.717,即模型区分度良好。结论本研究通过孕中晚期B超多参数预测胎儿体重,探索孕中晚期�Objective To explore and analyze the risk factors of premature delivery and adverse maternal and infant outcomes in pregnant women with preeclampsia using fetal weight in the second and third trimester,and build a risk prediction model.Methods A total of 160 singleton pregnant women with preeclampsia who were admitted to our hospital from January,2020 to August,2023 were selected as the research objects.The fetal weight of the pregnant women was estimated from 24+0 to 32+0 weeks of gestation.Pregnant women were divided into three groups according to gestational age and predicted weight:small gestational age(SGA)group(n=66),appropriate gestational age(AGA)group(n=75)and large gestational age(LGA)group(n=19).The general data of the pregnant women were collected,and all the pregnant women were followed up to one month after delivery.The incidence of preterm birth,delivery mode,and gestational age at delivery were observed and compared among the three groups.According to the occurrence of preterm birth and adverse maternal and infant outcomes,the pregnant women were divided into the occurrence group and the non-occurrence group.Multivariate Logistic regression analysis was used to establish a risk prediction model to predict related risk factors.Results There was a significant difference in the number of preterm births among the three groups(P<0.05).The gestational age at delivery in the SGA group was significantly lower than that in the AGA group and the LGA group,and the gestational age at delivery in the AGA group was significantly lower than that in the LGA group(P<0.05).There were statistically significant difference in childbirth way of natural childbirth,cesarean section,artificial induction among pregnant women(P<0.05).There were significant differences in maternal and infant infection, intrauterine distress and other delivery complications among the three groups ( P <0.05). There was no significant difference in postpartum neonatal sex and perinatal outcome among the three groups ( P >0.05). The birth weight

关 键 词：子痫前期孕妇 孕中晚期 胎儿体重 早产及母婴不良结局 风险预测模型 

分 类 号：R714.252[医药卫生—妇产科学]