双胎妊娠自发性早产的预测模型构建

Influencing factors of spontaneous preterm delivery in women with twin pregnancy and construction of a prediction model

目的分析双胎妊娠早产患者的临床特征,构建双胎妊娠自发性早产的预测模型。方法回顾性选择2020年1月至2024年2月嘉兴市妇幼保健院收治的双羊膜囊双胎妊娠孕妇200例,其中94例早产患者设为观察组,106例足月产患者设为对照组。收集并比较两组患者的一般资料,采用多因素logistic回归分析双胎妊娠自发性早产的影响因素,并建立预测模型,采用ROC曲线评价预测模型对双胎妊娠自发性早产的预测效能。结果观察组产时BMI、孕中期宫颈长度、产前Hb、妊娠糖尿病筛出率低于对照组,宫颈漏斗、妊娠期阴道炎、妊娠合并贫血发生率高于对照组,差异均有统计学意义(均P<0.05)。多因素logistic回归分析显示,产时BMI、孕中期宫颈长度、妊娠期阴道炎均为双胎妊娠孕妇自发性早产的独立影响因素(均P<0.05)。三者联合预测双胎妊娠自发性早产的效能更高,AUC为0.853。结论产时BMI、孕中期宫颈长度、妊娠期阴道炎三者联合对双羊膜囊双胎妊娠孕妇发生自发性早产有一定预测价值。

Objective To analyze the clinical features in twin pregnancy and to construct a prediction model of spontaneous preterm delivery in twin pregnancy.Methods A total of 200 pregnant women with twin pregnancy who delivered in Jiaxing Women and Children's Hospital from January 2020 to February 2024 were enrolled in the study,including 94 cases with preterm delivery(observation group)and 106 cases with full-term delivery(control group).General data were collected and compared with the two groups,the influencing factors of spontaneous preterm delivery were analyzed with multivariate logistic regression.The predictive model was established and the ROC curve was used to evaluate the predictive effect of the predictive model on the spontaneous preterm delivery in twin pregnancy.Results The rates of BMI,cervical length in the second trimester,prenatal hemoglobin and screening rate of gestational diabetes mellitus in observation group were lower than those in control group,and the incidence of cervical funnel,gestational vaginitis and anemia combined with pregnancy were higher than those in control group,with statistical significance(all P<0.05).Multivariate logistic regression analysis showed that BMI,cervical length in the second trimester and vaginitis during pregnancy were independent factors for spontaneous preterm delivery(all P<0.05).The combined prediction efficiency of the three methods was highest,with an AUC of 0.853.Conclusion The combination of BMI,cervical length in the second trimester and vaginitis during pregnancy has a certain predictive value for the delivery outcome of diamniotic sac twin pregnancy.