Risk factor analysis and establishment of risk prediction model for concomitant placental histological chorioamnionitis in patients with premature rupture of membranes
Objective To investigate the risk factors for concomitant histological chorioamnionitis(HCA)of the pla-centa in patients with preterm rupture of membranes and the establishment of risk prediction model.Methods Two hundred PROM patients of the First Affiliated Hospital of Xinjiang Medical University from May 2021 to May 2024 were selected,and the patients were divided into modelling group(140 patients)and validation group(60 patients).The modelling group was divided into HCA and non-HCA groups according to the presence or absence of concomitant HCA.The factors of concomitant HCA in PROM patients were analyzed by multifactorial logistic regression analysis;and the the nomogram model was con-structed by R software.ROC curves were plotted to assess the differentiation of the nomogram model model;clinical decision curves(DCA)were used to assess the clinical application value of the model.Results HCA occurred in 59 cases among 140 children,with an incidence of 42.14％.Lower genital tract infection,time to premature rupture of membranes,oligohydram-nios,amniotic fluid meconium contamination,WBC and CRP were significantly different between the two groups(P＜0.05).Multifactorial Logistic regression analysis of lower genital tract infection(OR=8.153,95％CI:2.299-28.908),time of preterm rupture of membranes(OR=5.201,95CI％:1.600-16.907),oligohydramnios(OR=7.526,95％CI:1.917-29.545),and amniotic fluid faecal contamination(OR=10.477,95％CI:2.929-37.477),WBC(OR=7.868,95％CI:2.245-27.573),and CRP(OR=4.057,95％CI:1.138-14.468)were the risk factors for HCA complication in patients with preterm premature rupture of membranes(P＜0.05).The AUC of the modelling group was 0.952,the slope of the calibration curve was close to 1,and the H-L test was x2=7.453,P=0.750.The AUC of the validation group was 0.961,the slope of the calibration curve was close to 1,and the H-L test was x2=7.018,P=0.720,and the DCA curves showed that the high risk threshold probability was of high value in the clinical use of the 0.04 to 0.93 range.Conclusion Lower genital tract infection,time to PROM,oligohydramnio,amni-otic fluid meconium contamination,WBC and CRP were the factors influencing the complication of HCA in patients with PROM,and the nomogram model constructed by this method is good and can predict the risk of HCA in PROM patients.
premature rupture of membranesplacental histological chorioamnionitisrisk factorsnomogram
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NSTL
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