Influencing factors of adverse pregnancy outcomes in patients with pregnancy complicated with systemic lupus erythematosus and construction of a nomogram prediction model
Objective To analyze the relevant factors that affect the adverse pregnancy outcomes of patients with sys-temic lupus erythematosus(SLE)during pregnancy,and to construct a nomogram prediction model.Methods A total of 314 patients with pregnancy complicated with SLE were collected.A computer randomized grouping method was used in a 7:3 ratio,with 220 patients as the modeling group and the remaining 94 patients as the validation group;according to the pregnancy outcomes of pregnant women with SLE in the modeling group,they were grouped into the poor pregnancy outcome group(73 cases)and the good pregnancy outcome group(147 cases).Logistic regression model was applied to analyze the influencing factors of pregnancy outcomes in patients with pregnancy complicated with SLE,and then a nomogram predic-tion model was constructed using R software;ROC curve,calibration curve and H-L Goodness of fit test were applied to veri-fy the prediction efficiency of the constructed nomogram prediction model.Results The results of multivariate Logistic re-gression analysis showed that lupus nephritis,preeclampsia,Raynaud phenomenon,anti-SSA antibody(+),SLE disease activity score(SLEDAI),thrombocytopenia,and renal dysfunction were risk factors for adverse pregnancy outcomes in pregnant women with SLE(all P<0.05).Based on these seven influencing factors,a nomogram model was constructed.The area under the ROC curve of the modeling group in verifying the nomogram model was 0.893(95%CI:0.844-0.930),the calibration curve slope was close to 1,and the discrimination was good(H-L test χ2=8.877,P=0.342);the ar-ea under the ROC curve of the validation group was 0.831(95%CI:0.740-0.901),and the slope of the calibration curve was close to 1,the H-L test results showed that the constructed prediction model had high consistency with the actual out-come(χ2=6.436,P=0.599).Conclusions Lupus nephritis,preeclampsia,Raynaud phenomenon,anti-SSA antibody(+),SLEDAI,thrombocytopenia,and renal dysfunction were risk factors for adverse pregnancy outcomes in pregnant wom-en with SLE.The nomogram model constructed based on the seven risk factors screened by the Logistic regression model has good predictive value for the pregnancy outcome of patients with pregnancy complicated with SLE.
pregnancy associated with systemic lupus erythematosuspregnancy outcomenomogram prediction model
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