Construction and Verification of Risk Prediction Nomogram Model for Preeclampsia Complicated with Fetal Growth Restriction
Objective To explore the influencing factors of preeclampsia complicated with fetal growth restriction(FGR),and to establish a nomogram prediction model.Methods The clinical data of 168 patients with preeclampsia admitted to Zhengzhou People's Hospital from December 2018 to December 2022 were retrospectively analyzed.According to the ratio of 2∶1,they were divided into modeling group(112 cases)and verification group(56 cases).According to whether FGR was complicated,the modeling group was divided into concurrent group(49 cases)and non-concurrent group(63 cases).Multivariate logistic regression analysis was used to analyze the influencing factors of preeclampsia complicated with FGR,and R3.4.3 software package was used to draw the nomogram model,and Bootstrap method was used for internal verification.The receiver operating characteristic(ROC)curve was drawn to analyze the efficacy of the nomogram in predicting preeclampsia complicated with FGR,and the decision curve analysis(DCA)was used to verify the clinical net benefit rate of the model.Results The proportions of gestational age＜34 weeks,oligohydramnios,systolic blood pressure ≥160 mmHg,fetal umbilical artery systolic blood pressure/diastolic blood pressure ratio(S/D)ratio increased,24 h urine protein quantification≥ 2.0 g and levels of hemoglobin(HB),aspartate aminotransferase(ASI),blood uric acid(UA),blood urea nitrogen(BUN),creatinine,D-dimer(D-D)in the concurrent group were higher than those in the non-concurrent group(P＜0.05),albumin level and prothrombin time(PT)were lower than those in the non-concurrent group(P＜0.05).Logistic regression analysis showed that gestational age＜34 weeks,oligohydramnios,increased S/D ratio,24 h urinary protein quantification ≥2.0 g,elevated BUN and D-D levels were risk factors for preeclampsia complicated with FGR(P＜0.05),and albumin was its protective factor(P＜0.05).Based on the above influencing factors,a nomogram model of preeclampsia complicated with FGR was constructed.The Bootstrap method was used for internal verification,and the consistency index was 0.825,and the calibration curve and standard curve fit was good.ROC curve results showed that the area under the curve(AUC),sensitivity and specificity of the modeling group nomogram for predicting preeclampsia complicated with FGR were 0.862,83.67％and 87.30％,respectively.The AUC,sensitivity and specificity of the validation group nomogram in predicting preeclampsia complicated with FGR were 0.830,80.77％and 83.33％,respectively.DCA suggested that the nomogram model can obtain satisfactory net income for risk assessment.Conclusion The gestational age of onset＜34 weeks,oligohydramnios,elevated S/D ratio,24-hour urinary protein quantification≥ 2.0 g,elevated BUN and D-D levels levels are all risk factors for preeclampsia complicated with FGR,and albumin is a protective factor.The clinical application value of the nomogram model constructed based on this is high,which can provide reference for clinical screening of high-risk patients with preeclampsia complicated with FGR.
preeclampsiafetal growth restrictionnomogramprediction model
万方数据
维普
