Exploring the risk factors of extremely premature delivery in twin pregnancies and establishing a risk prediction model
Objective:To explore the risk factors for extremely premature delivery in twin pregnancies and estab-lish relevant risk prediction model.Methods:The clinical data of 823 pregnant women with twin pregnancies ad-mitted to our hospital from June 2016 to December 2022 were retrospectively analyzed,and they were divided into modeling set(n=549)and validation set(n=274)according to the ratio of 2∶1.Pregnant women with twin preg-nancies were divided into extremely premature delivery group(gestational age＜32 weeks)and non-extremely pre-mature delivery group(gestational age ≥ 32 weeks)based on pregnancy outcomes.Logistic regression analysis was used to screen for risk factors of extremely premature delivery in twin pregnancies,and the risk prediction model was constructed and validated.Results:There were no statistically significant differences in the comparisons of clinical data between the modeling set and the validation set(P＞0.05).The Logistic regression analysis results of the modeling set showed that single chorionic villi,gestational hypertension,premature rupture of membranes,scar uterus and chorioamnionitis were risk factors for extremely premature delivery in twin pregnancies(P＜0.05).Based on the above 5 indicators,the risk prediction model for extremely premature delivery of twin pregnancies was established.The calibration curve showed good consistency between the calibration curve and the ideal curve of the risk prediction model,and the consistency index of the modeling set and validation set were 0.829(95％CI:0.782-0.873)and 0.818(95％CI:0.763-0.856),respectively.The receiver operating characteristic curve showed that the area under the curve of the modeling set and the validation set with extremely premature delivery by the model were 0.839(95％CI:0.801-0.875),0.826(95％CI:0.775-0.869),respectively.The decision curve showed that pregnant women with twin pregnancies had higher net benefit in predicting the occurrence of extremely prema-ture delivery based on this model.Conclusion:The predictive efficacy and applicability of the risk prediction mod-el for extremely premature delivery in twin pregnancies based on single chorionic villi,gestational hypertension,premature rupture of membranes,scar uterus,and chorioamnionitis are good,and it can be used to screen for the risk of extremely premature delivery in pregnant women with twin pregnancies.
twin pregnanciesextremely premature deliveryrisk factorrisk prediction model
万方数据
维普
