早产的高危因素评估及预测方法

Assessment and Prediction of Risk Factors for Preterm Birth

早产是由多因素共同导致的妊娠并发症,其病因目前尚未完全阐明,可能与孕妇营养状况及疾病、配偶及环境等因素有关。宫颈长度和胎儿纤连蛋白水平在早产方面具有良好的预测价值。弹性成像、宫颈前角、胎膜厚度等超声指标以及炎症因子、胎儿细胞游离DNA等实验室指标、磁共振成像、子宫肌电活动图等也有助于早产的预测,但其预测价值仍待进一步研究验证。近年Creasy评分法、QUIPP均已应用于临床,但预测效能欠佳。机器学习技术因具有整体性、系统性等已成为目前研究的热点,但其模型结构仍需进一步优化。未来深入研究早产高危因素的评估预测方法,可以为疾病的预防提供新思路。

Preterm birth is a complication of pregnancy caused by many factors.The etiology of preterm birth has not been fully clarified at present,which may be related to the nutritional status and disease,spouse and environmental factors.Cervical length and fetal fibronectin levels are reliable predictors of preterm birth.Ultrasound indicators such as cervical elastography,cervical anterior angle and fetal membrane thickness,as well as laboratory indicators such as inflammatory factors,fetal cell free DNA,MRI and uterine electromyography,etc.are also helpful for the prediction of preterm labor,but their predictive value remains to be verified by further studies.In recent years,both Creasy score and Quantitative Instrument for the Prediction of Preterm Birth(QUIPP)App have been applied in clinical practice,but their predictive efficacy is not good.Machine learning technology has become a research hotspot due to its integrity and systematicness,but its model structure still needs to be further optimized.In the future,in-depth research on the assessment and prediction methods of high risk factors of premature birth can provide new ideas for the disease prevention.