Objective To analyze the influencing factors of adverse outcomes of gestational diabetes mellitus and establish a prediction model according to the influencing factors and its verification.Methods A total of 370 pregnant and lying in women who were admitted to the ob-stetric clinic of the First Maternal and Child Health Hospital affiliated to Tongji University from March 2021 to March 2022 and were diagnosed as gestational diabetes were selected for prenatal examination and hospital delivery.According to whether the gestational diabetes patients had adverse outcomes during pregnancy or postpartum,the objects of modeling were divided into two groups:normal outcome group(n=228)and adverse outcome group(n=142).The risk factors of adverse outcomes of gestational diabetes mellitus were analyzed by using Univariate analysis and multivariate Logistic regression,and the prediction model was established.The predictive efficacy of the predictive model for predicting the risk of adverse outcomes in patients with gestational diabetes mellitus was to evaluated by drawing receiver operating characteristic(ROC)curve,and the practical application efficacy of the model was verified by sensitivity,specificity and total accuracy.Results Univariate analysis and multivariate Logistic regression analysis showed that age ≥35 years old,pregnancy history ≥2 times,pre-pregnancy body mass index＞28 kg/m2,family history of diabetes,delivery mode of cesarean section,frequency of abortion more than 2 times and OGTT blood glucose were the risk factors for ad-verse outcomes in gestational diabetes patients.And construct the prediction model.The neomorph model could well predict the adverse outcomes of gestational diabetes mellitus patients.The area under the curve was 0.938(95％Cl:0.897-0.975),sensitivity was 0.873,and specificity was 0.792,indicating that the neomorph model had good prediction accuracy.Hosmer Lemeshow test showedx2=4.178,P=0.146,indicating that the model was well calibrated.The calibration plot of the model shows a good agreement between the probability of adverse outcomes and the actual observed probability.External verification of 165 patients with gestational diabetes mellitus had adverse outcomes in 61 cases.The sensitivi-ty and specificity of the risk prediction model to predict poor prognosis in the validation group were 89.27％and 92.48％.The total accuracy of the model was 90.91％.Conclusion Age ≥35 years old,gestational history ≥2 times,pre-pregnancy body mass index＞28 kg/m2,family history of diabetes,delivery mode of cesarean section,frequency of abortion more than 2 times and abnormal OGTT blood glucose were the influen-tial factors for adverse outcomes of gestational diabetes.The nomogram prediction model has high predictive efficiency and clinical applicability for the adverse outcomes of gestational diabetes mellitus,and has certain potential significance for the identification of adverse outcomes of gestational diabetes mellitus.
维普
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