Construction of Risk Forecasting Model for Spontaneous Abortion in Patients with Pregnancy Complicated with Hypothyroidism
Objective:To investigate the risk factors of spontaneous abortion in patients with pregnancy complicated with hypothyroidism and construct a forecasting model,in order to provide more guidance for accurate identification and early intervention of spontaneous abortion high-risk groups.Method:A total of 278 patients with pregnancy complicated with hypothyroidism treated in Yichun Maternal and Child Health Hospital from January 2018 to January 2023 were retrospectively included,and they were divided into spontaneous abortion group(n=40)and pregnancy group(n=238)according to whether spontaneous abortion occurred.Independent risk factors for spontaneous abortion in patients with pregnancy complicated with hypothyroidism were evaluated by univariate and multivariate analysis,and a partial regression coefficient model equation was constructed based on independent risk factors,and the clinical efficacy of this model in predicting spontaneous abortion risk in patients with pregnancy complicated with hypothyroidism was analyzed.Result:The results of single factor analysis showed that there were statistically significant differences in the levels of glycosylated hemoglobin,triglyceride,homocysteine(Hcy),thyroid stimulating hormone(TSH)and thyroid peroxidase antibody(TPOAb)positive between the two groups(P<0.05).Multivariate analysis results of logistic regression model showed that high levels of glycosylated hemoglobin,triglyceride,Hcy,TSH and TPOAb positive were independent risk factors of spontaneous abortion in patients with pregnancy complicated with hypothyroidism(P<0.05).According to the independent risk factors of spontaneous abortion in patients with pregnancy complicated with hypothyroidism confirmed by logistic regression model,the independent variable partial regression coefficient model equation was constructed:the spontaneous abortion risk of patients with pregnancy complicated with hypothyroidism logit(Y)=1.68+1.63×glycosylated hemoglobin(%)+1.85×triglyceride(mmol/L)+1.48×Hcy(μmol/L)+0.60×TSH(mIU)+0.96×TPOAb positive.Receiver operating characteristic(ROC)curve analysis results showed that the area under the curve of the above clinical model for predicting the risk of spontaneous abortion in patients with pregnancy complicated with hypothyroidism was 0.90[95%CI(0.85,0.97)],the optimal cut-off value was 8.65,and the sensitivity and specificity respectively was 86.15%and 80.78%.Conclusion:The occurrence of spontaneous abortion in patients with pregnancy complicated with hypothyroidism is associated with high glycosylated hemoglobin level,high triglyceride level,high Hcy level,low TSH level and TPOAb positive,and the forecasting model based on the above indicators shows good value in guiding clinicians to accurately identify high-risk groups of spontaneous abortion at an early stage.
PregnancyHypothyroidismSpontaneous abortionRisk factorsForecasting model
万方数据
维普
