延期妊娠孕妇阴道试产失败的影响因素及预测模型构建  

Influencing factors and prediction model construction of vaginal trial delivery failure in pregnant women with prolonged pregnancy

作　　者：陈明彧 庞冬 CHEN Mingyu;PANG Dong(Department of Obstetrics,the People’s Hospital of Guangxi Zhuang Autonomous Region,Guangxi Zhuang Autonomous Region,Nanning 530021,China)

机构地区：[1]广西壮族自治区人民医院产科,广西南宁530021

出　　处：《妇儿健康导刊》2025年第2期188-192,共5页JOURNAL OF WOMEN AND CHILDREN'S HEALTH GUIDE

基　　金：广西壮族自治区卫生健康委员会自筹经费科研课题(Z20210554)。

摘　　要：目的分析延期妊娠孕妇阴道试产失败的影响因素及构建预测模型。方法回顾性分析广西壮族自治区人民医院2019年1月至2024年1月收治的178例延期妊娠孕妇的临床资料,根据是否阴道试产成功将其分为对照组(140例,阴道试产成功)、观察组(38例,阴道试产失败)。采用单因素及多因素logistic回归分析延期妊娠孕妇阴道试产失败的影响因素,并建立预测模型,采用受试者操作特征(ROC)曲线评估列线图模型的价值。结果单因素分析结果显示,与对照组比较,观察组年龄>35岁、体重指数≥26 kg/m^(2)的占比更高,入院时宫颈Bishop评分更低,宫颈长度更长(P<0.05)。多因素分析结果显示,年龄>35岁、体重指数≥26 kg/m^(2)、宫颈长度长为延期妊娠孕妇阴道试产失败的独立危险因素(P<0.05);入院时宫颈Bishop评分高是延期妊娠孕妇阴道试产失败的保护因素(P<0.05)。列线图预测延期妊娠孕妇阴道试产失败的ROC曲线下面积为0.991,灵敏度为96.43%,特异度为94.74%。结论年龄>35岁、体重指数≥26 kg/m^(2)、宫颈长度长为延期妊娠孕妇阴道试产失败的独立危险因素,入院时宫颈Bishop评分高为保护因素,相关预测模型预测价值较高。Objective To analyze the influencing factors of vaginal trial delivery failure in pregnant women with prolonged pregnancy and construct a prediction model.Methods The clinical data of 178 pregnant women with prolonged pregnancy admitted to the People’s Hospital of Guangxi Zhuang Autonomous Region from January 2019 to January 2024 were retrospectively analyzed.According to whether vaginal trial delivery was successful or not,they were divided into control group(140 cases,vaginal trial delivery was successful)and observation group(38 cases,vaginal trial delivery failed).Univariate and multivariate logistic regression were used to analyze the influencing factors of vaginal trial delivery failure in pregnant women with prolonged pregnancy,and a prediction model was established.The receiver operating characteristic(ROC)curve was used to evaluate the value of the nomogram model.Results Univariate analysis showed that compared with the control group,the proportion of age>35 years old and body mass index≥26 kg/m^(2)in the observation group was higher,the cervical Bishop score at admission was lower,and the cervical length was longer(P<0.05).Multivariate analysis showed that age>35 years old,body mass index≥26 kg/m^(2),and long cervical length were independent risk factors for vaginal trial delivery failure in pregnant women with prolonged pregnancy(P<0.05).The high cervical Bishop score at admission was a protective factor for vaginal trial delivery failure in pregnant women with prolonged pregnancy(P<0.05).The area under the ROC curve of the nomogram for predicting the vaginal trial delivery failure in pregnant women with prolonged pregnancy was 0.991,with a sensitivity of 96.43%and a specificity of 94.74%.Conclusion Age>35 years,body mass index≥26 kg/m^(2),and long cervical length are independent risk factors for vaginal trial delivery failure in pregnant women with prolonged pregnancy,and a high cervical Bishop score at admission is a protective factor.The prediction model has high predictive value.

关 键 词：延期妊娠 阴道试产 影响因素 预测模型 

分 类 号：R714[医药卫生—妇产科学]