首页|GDM孕妇分娩巨大儿风险预测模型的构建

GDM孕妇分娩巨大儿风险预测模型的构建

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目的:探讨妊娠期糖尿病(GDM)孕妇分娩巨大儿的危险因素,并构建相关风险预测模型.方法:回顾性收集2022年1-12月在杭州市妇产科医院/杭州市妇幼保健院建档立卡并分娩的218例GDM孕妇临床资料.根据新生儿出生体重分为巨大儿组(27例)和正常体重儿组(191例),采用logistic回归分析GDM孕妇分娩巨大儿的危险因素,并应用R软件建立风险模型列线图;并绘制校准曲线图.结果:218例GDM孕妇分娩巨大儿27例,发生率为12.4%.孕前体质质量(BMI)≥28kg/m2(OR=5.410,95%CI 2.142~11.938)、孕期体重增长>14kg(OR=3.056,95%CI 1.427~7.016)、孕周延长(OR=2.724,95%CI 1.180~5.794)、妊娠晚期空腹血糖(FBG)≥4.7mmol/L(OR=3.218,95%CI 1.049~5.801)、血清甘油三酯(TG)≥2.9mmol/L(OR=1.841,95%CI 1.132~4.017)为 GDM 孕妇分娩巨大儿的独立危险因素.以此建立GDM孕妇发生巨大儿的列线图模型,模型曲线下面积AUC值为0.921(95%CI 0.896~0.938),灵敏度为83.7%,特异度为86.9%.提示模型准确性尚可.结论:GDM孕妇分娩巨大儿与孕前肥胖、孕期体重增长过高、孕周延长,甘油三酯、空腹血糖水平升高等因素有关.预测模型的区分度良好,可以科学、直观、简便的识别存在发生巨大儿风险的GDM孕妇.
Establishment of the macrosomia delivery risk prediction model of pregnant women with gestational diabetes mellitus
Objective:To explore the risk factors of the macrosomia delivery of pregnant women with gestational diabe-tes mellitus(GDM),and to establish the relative risk prediction model of macrosomia.Methods:The clinical data of 218 pregnant women with GDM who were registered and delivered in hospital from January to December 2022 were collected retrospectively,including 27 cases with macrosomia in study group and 191 cases with normal weight of the newborns in control group.The risk factors of the macrosomia delivery of the women with GDM were analyzed by lo-gistic regression analysis.R software was used to establish the nomogram model of macrosomia GDM,and a calibra-tion curve was drawn.Results:Among 218 pregnant women with GDM,27 cases delivered macrosomia,with an inci-dence of 12.4%.The BMI28kg/m2 before pregnancy(OR=5.410,95%CI 2.142-11.938),the weight gain during preg-nancy>14kg(OR=3.056,95%CI 1.427-7.016),the prolonged of the gestational weeks(OR=2.724,95%CI 1.180-5.794),the fasting blood glucose level ≥4.7mmol/L during the third trimester of pregnancy(OR=3.218,95%CI 1.049-5.801),the triglycerides(TG)level ≥2.9mmol/L(OR=1.841,95%CI 1.132-4.017)of the women with GDM were the independent risk factors of their macrosomia,and a nomogram model for predicting the macrosomia occur-rence of the pregnant women with GDM was established based on these independent risk factors.The area under the curve(AUC)of the model curve for predicting the macrosomia was 0.921(95%CI 0.896-0.938),and the sensitivity and the specificity of which were 83.7%and 86.9%,and the AUC,and the sensitivity and the specificity indicated that the accuracy of the model was acceptable.Conclusion:The pregnant women with GDM complicated with macrosomia are related to their obesity before pregnancy,excessive weight gain during pregnancy,prolonged gestational weeks,and the elevated levels of TG and FBG.The prediction model for the macrosomia is well differentiated,and which can scientifically,intuitively and simply identify the risk of macrosomia of the pregnant women with GDM.

Gestational diabetes mellitusMacrosomiaRisk factorPrediction model

程默、陈冠杰、楼梦晓

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浙江省杭州市妇产科医院,浙江省杭州市妇幼保健院(310008)

妊娠期糖尿病 巨大儿 危险因素 预测模型

2024

中国计划生育学杂志
国家人口计生委科学技术研究所

中国计划生育学杂志

CSTPCD
影响因子:1.759
ISSN:1004-8189
年,卷(期):2024.32(1)
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