基于子宫动脉血流参数的Logistic回归模型在妊娠期高血压患者不良分娩结局的预测价值

Predictive Value of Logistic Regression Model Based on Uterine Artery Blood Flow Parameters on Adverse Delivery Outcomes in Patients with Hypertensive Disorder of Pregnancy

目的:探究子宫动脉血流参数的Logistic回归模型在妊娠期高血压(HDP)患者不良分娩结局的预测价值。方法:选取2022年4月至2023年6月在我院接受产前检查的203例HDP患者为研究对象(HDP组),同期纳入100例无流产史的妊娠女性作为对照组。所有孕妇均在孕中期进行子宫动脉血流参数检测。比较HDP组和对照组入院时搏动指数(PI)、阻力指数(RI)、收缩期峰值流速/舒张期流速比值(S/D)。通过Logistic回归分析确定与不良分娩结局相关的独立预测因素。通过受试者操作特征(ROC)曲线分析Logistic模型的预测效能。结果:HDP组PI、RI和S/D值均显著高于对照组(P<0.05)。203例HDP患者中,发生不良妊娠结局的有135例,不良妊娠结局发生率为66.50%。Logistic回归模型显示,PI、RI、S/D比值均为HDP患者不良分娩结局发生的独立危险因素(P<0.05)。基于子宫动脉血流参数构建Logistic回归模型预测不良分娩结局的AUC为0.952,SE为0.324,95%CI为0.913~0.977(P<0.001),敏感度为0.896,特异度为0.956,约登指数0.852。结论:子宫动脉血流参数在预测HDP患者不良分娩结局风险方面具有重要意义,可作为临床风险评估的有效工具。

Objective:To explore the predictive value of Logistic regression model of uterine artery blood flow parameters on the adverse delivery outcomes in patients with hypertensive disorder of pregnancy(HDP).Methods:A total of 203 HDP patients who received prenatal examination in the hospital from April 2022 to June 2023 were selected as the study subjects(HDP group),and 100 pregnant women without abortion history were included in control group.All pregnant women were tested for uterine artery blood flow parameters in the second trimester.The pulsatility index(PI),resistance index(RI),and the ratio of peak systolic velocity to diastolic velocity(S/D)were assessed.Independent predictors of adverse delivery outcomes were identified using logistic regression analysis.The effectiveness of the logistic model in predicting outcomes was evaluated through receiver operating characteristic(ROC)curve analysis.Results:The PI,RI and S/D in HDP group were significantly higher than those in control group(P<0.05).Among the 203 patients with HDP,135 cases had adverse pregnancy outcomes,with the incidence rate of 66.50%.Logistic regression model showed that PI,RI,S/D ratio were independent risk factors for adverse delivery outcomes in HDP patients(P<0.05).The AUC,SE and 95%CI of logistic regression model based on uterine artery blood flow parameters were 0.952,0.324 and 0.913-0.977 in predicting the adverse delivery outcomes(P<0.001),and the sensitivity,specificity and Youden indexes were 0.896,0.956 and 0.852.Conclusion:Uterine artery blood flow parameters are of great significance in predicting the risk of adverse delivery outcomes in patients with HDP,and can be used as an effective tool for clinical risk assessment.