妊娠糖尿病孕妇早产风险的预测模型构建与验证  

Construction and validation of prediction model for premature delivery risk of pregnant women with gestational diabetes mellitus

作　　者：曾文玉 王泯蓉 邓夏 高靖 ZENG Wenyu;WANG Minrong;DENG Xia;GAO Jing(Department of Obstetrics and Gynecology,Mianyang Central Hospital,School of Medicine,University of Electronic Science and Technology of China,Mianyang,Sichuan 621000,China)

机构地区：[1]电子科技大学医学院附属绵阳医院·绵阳市中心医院妇产科,四川绵阳621000

出　　处：《中国优生与遗传杂志》2024年第8期1626-1630,共5页Chinese Journal of Birth Health & Heredity

基　　金：2021年四川省医学(青年创新)科研课题项目(S21841)。

摘　　要：目的分析妊娠糖尿病孕妇发生早产的影响因素,并构建预测模型。方法回顾性分析2022年1月至2023年10月电子科技大学医学院附属绵阳医院·绵阳市中心医院妇产科收治的165例妊娠糖尿病孕妇,根据孕妇是否发生早产将其分为早产组(43例)和足月组(122例)。收集所有孕妇的临床资料,通过多因素Logistic回归分析探讨与妊娠糖尿病孕妇早产相关的危险因素,构建预测模型并进行验证。结果妊娠糖尿病孕妇早产的发生率为26.06%(43/165)。经多因素Logistic回归分析显示,孕妇年龄及孕前BMI增加、妊娠高血压、流产史、早产史、孕晚期外周血白细胞水平≥10×10^(9)/L、OGTT空腹血糖≥5.1 mmol/L均是其发生早产的危险因素(P<0.05);据此构建列线图的模型ROC曲线下面积(AUC)为0.882(95%CI:0.814~0.931),提示该模型具有良好的预测效能;Hosmer-Lemeshow检验结果中χ^(2)=0.652,P=0.730,校准曲线与标准曲线表现出良好的一致性。结论本研究确定了与妊娠糖尿病孕妇发生早产有关的7项指标并构建相关模型,有助于临床筛选高风险孕妇,减少早产的发生。Objective To analyze the influencing factors of preterm birth in pregnant women with gestational diabetes mellitus and establish a prediction model.Methods 165 pregnant women with gestational diabetes admitted to our hospital from January 2022 to October 2023 were retrospectively analyzed and divided into preterm group(43 cases)and term group(122 cases)according to whether they had preterm birth.The clinical data of all pregnant women were collected,multivariate Logistic regression analysis was used to explore the risk factors associated with preterm delivery in pregnant women with gestational diabetes mellitus,and the prediction model was constructed and verified.Results The incidence of preterm delivery was 26.06%(43/165)in pregnant women with gestational diabetes.Logistic regression analysis showed that age and pre-pregnancy BMI increase,gestational hypertension,history of abortion,history of preterm birth,peripheral white blood cell level≥10×10^(9)/L in late pregnancy,OGTT fasting blood glucose≥5.1 mmol/L were all risk factors for preterm birth in pregnant women with gestational diabetes(P<0.05).Based on the above risk factors,a nomogram model was constructed.The area under the curve(AUC)was 0.882(95%CI:0.814-0.931),suggesting that the model has good predictive efficacy.In the results of the Hosmer-Lemeshow testχ^(2)=0.652,P=0.730,the calibration curve showed good consistency with the standard curve.Conclusion This study identified 7 indicators related to preterm birth in pregnant women with gestational diabetes mellitus and built a related model,which is helpful for clinical screening of high-risk pregnant women and reduce the occurrence of preterm birth.

关 键 词：妊娠糖尿病 早产 危险因素 列线图模型 

分 类 号：R714.256[医药卫生—妇产科学]