Analysis of the risk factors of the occurrence of hypertensive disorders of pregnancy(HDP)and the predictive value of re-gression models based on the risk factors
Objective:To explore the risk factors of the occurrence of hypertensive disorders of pregnancy(HDP)of women,and to study the predictive value of regression models based on the risk factors of the women for their HDP.Methods:172 pregnant women with HDP from January 2020 to May 2022 were selected in study group retrospective-ly,and 196 pregnant women without HDP were randomly selected in control group during the same period.The clini-cal data of the women were compared between the two groups.The risk factors of the HDP occurrence of the women were analyzed by multivariate logistic regression analysis.The prediction model based on these risk factors was con-structed,and the predictive value of the model for HDP occurrence was analyzed by receiver operating characteristic(ROC)curve.The pregnancy outcomes of the women in the two groups were compared.Results:The scores of self-rating depression scale(SDS)and self-rating anxiety scale(SAS)of the women in the study group were significantly higher than those of the women in the control group.In the study group,the proportions of the age ≥35 years old,the below junior college of education level,the living in rural area,the poor family economic status,the experiencing ad-verse life events,the insufficient calcium intake during pregnancy,the overweight before pregnancy,the irregular pre-natal examination,the passive smoking,the family history of hypertension,and the gestational diabetes mellitus of the women in the study group were 15.12％,48.84％,12.21％,34.88％,23.84％,,27.33％,36.63％,21.51％,26.74％,30.81％and 25.00％,respectively,which were significantly higher than those(3.06％,31.12％,2.04％,18.88％,10.71％,18.37％,8.16％,5.61％,17.86％,7.14％,and 7.14％,respectively)of the women in the control group(P＜0.05).Multivariate logistic regression analysis showed that the age ≥35 years old,the overweight before pregnancy,the insufficient calcium intake during pregnancy,the irregular prenatal examination,the family history of hypertension,and the gestational diabetes mellitus of the women were the independent risk factors of their HDP occur-rence(OR=1.902,2.812,2.477,2.158,1.966 and 3.428,P＜0.05).The regression equation model was logit(P)=-10.764+age × 0.643+overweight before pregnancy × 1.034+insufficient calcium intake during pregnancy X 0.907+regular prenatal examination × 0.769+family history of hypertension × 0.676+gestational diabetes mellitus × 1.232.ROC curve showed that when logit(P)＞12.31,the area under the curve(AUC)value was 0.898,x2 was 24.984,and 95％CI was 0.863-0.927,the diagnostic specificity was 80.6％,and the sensitivity was 84.9％.The inci-dence of the adverse fetal pregnancy outcomes(26.7％)of the women in the study group was significantly higher than that(3.6％)of the women in the control group(P＜0.05).Conclusion:HDP of the pregnant women might increase the risk of their adverse pregnancy outcomes.The age ≥ 35 years old,the overweight before pregnancy,the insuffi-cient calcium intake in pregnancy,the irregular prenatal examination,the family history of hypertension and the gesta-tional diabetes mellitus of the pregnant women are the independent risk factors of their HDP occurrence,and the re-gression model has higher predictive value for these risk factors.These risk factors should be identified early and the targeted intervention measures should be conducted,so as to reduce the risk of HDP of the women in clinic.
Hypertensive disorders of pregnancyRisk factorsRegression modelPredictive valuePregnancy out-comes
万方数据
维普
