Construction of Risk Prediction Model for Adverse Pregnancy Outcome in Primipara with Gestational Diabetes Mellitus Combined with Pregnancy-In-duced Hypertension Syndrome
Objective To investigate the risk factors of adverse pregnancy outcomes in primipara with gestational dia-betes mellitus(GDM)combined with pregnancy-induced hypertension syndrome(PIH),and to establish a prediction model.Methods A total of 120 primipara with GDM combined with PIH admitted from January 2019 to May 2023 were selected and divided into poor group(n =57)and good group(n =63)according to pregnancy outcomes.Multivariate Logistic regression analysis was used to screen the risk factors affecting adverse pregnancy outcomes in these patients,based on which a nomo-gram model was constructed for validation and efficacy evaluation.Results The proportion of elderly parturient women,pre-pregnancy body mass index(BMI),increase of body mass during pregnancy,proportion of family history of diabetes,PIH type,HbA1c,and total cholesterol(TC)were higher in poor group than in good group,while high density lipoprotein choles-terol(HDL-C)was lower than that in good group(P<0.01,P<0.05).Multivariate Logistic regression analysis showed that elderly parturients,pre-pregnancy BMI,family history of diabetes,preeclampsia/chronic hypertension complicated with pre-eclampsia,eclampsia and HbA1c were independent risk factors for adverse pregnancy outcomes in parturients with GDM com-bined with PIH(P<0.01).According to the results of multivariate Logistic regression analysis,the prediction model equa-tion of GDM combined with PIH adverse pregnancy outcome was established and the nomogram model was constructed.The re-ceiver operating characteristic(ROC)curve showed that the area under the ROC curve(AUC)was 0.821,the Bootstrap in-ternal verification showed that the differentiation was good,and the Calibration curve showed that the fit was good.Conclusion There are various factors affecting the adverse pregnancy outcomes of primipara with GDM combined with PIH,and elderly women,pre-pregnancy BMI,family history of diabetes,preeclampsia/chronic hypertension complicated with preeclampsia,eclampsia,and HbA1c are independent risk factors.The risk prediction nomogram model based on risk factors has high pre-dictive efficacy for adverse pregnancy outcomes.
万方数据
维普
