Analysis of risk factors for adverse pregnancy outcomes in pregnant women with gestational diabetes mellitus and construction of a Nomogram prediction model
Objective To analyze the risk factors for adverse pregnancy outcomes in pregnant women with gestational diabetes mellitus and construct a Nomogram prediction model.Methods A total of 290 patients with gestational diabetes mellitus admitted to the Second Affiliated Hospital of Guangdong Medical University and Shunde Women's and Children's Hospital of Guangdong Medical University(Shunde District Maternal and Child Health Hospital)from January 2020 to May 2022 were selected as the study subjects,and they were divided into the occurrence group(n =105)and the non-occurrence group(n =185)according to whether they had adverse pregnancy outcomes.At the same time,150 patients with gestational diabetes mellitus from the same hospital during the same period were selected as the model-testing group,and the data of the model-testing group were used to validate the established prediction model of the risk of adverse pregnancy outcomes in pregnant women with gestational diabetes mellitus.The predictive value of continuous variables was analyzed by plotting receiver operating characteristic(ROC)curves.The risk factors affecting the occurrence of adverse pregnancy outcomes in pregnant women with gestational diabetes mellitus were analyzed by Logistic regression.The clinical efficacy of Nomogram model was verified by using internal data.Results Compared with the non-occurrence group,patients in the occurrence group were older in age,higher in pre-pregnancy body mass index(BMI),and triglycerides(TC),had a higher proportion of family history of diabetes mellitus,abnormalities in three blood glucose indexes of the oral glucose tolerance test(OGTT),and a history of adverse pregnancy and childbirth(P＜0.05).The areas under the ROC curve(AUC)for age,pre-pregnancy BMI,and TC were 0.722,0.635,and 0.598,respectively.Age,pre-pregnancy BMI,TC,family history of diabetes mellitus,abnormalities in three blood glucose indexes of OGTT,and history of adverse pregnancy and childbirth were all risk factors affecting the occurrence of adverse pregnancy outcomes in patients with gestational diabetes mellitus.The Nomogram model predicted that the risk of adverse pregnancy outcomes in patients with gestational diabetes mellitus had a C-index of 0.757(95%CI:0.679-0.871).The risk threshold for predicting adverse pregnancy outcomes in patients with gestational diabetes mellitus by the model was＞0.07.In the validation of the model,the results of the ROC curve showed an AUC of 0.836(95%CI:0.774-0.898),and the H-L goodness-of-fit test showed χ2 =11.219,P =0.219.Conclusions Age,pre-pregnancy BMI,TC,family history of diabetes mellitus,abnormalities in three blood glucose indexes of OGTT,and history of adverse pregnancy and delivery are all risk factors for adverse pregnancy outcomes in patients with gestational diabetes mellitus,and the model constructed on the basis of the variables has good predictive ability.
Gestational diabetes mellitusAdverse pregnancy outcomeRisk factorsNomogram prediction model
NETL
NSTL
万方数据
维普
