Risk factors and prediction model for fetal growth restriction in patients with gestational hypertension during late pregnancy
10.3760/cma.j.cn431274-20230914-00265
- VernacularTitle:妊娠期高血压疾病患者孕晚期发生胎儿生长受限的危险因素及预测模型的建立
- Author:
Lizhu GUO
1
;
Daoxu HAN
;
Jishui WANG
;
Chunxia WANG
Author Information
1. 济宁医学院附属医院妇产科，济宁 272100
- Keywords:
Hypertension, pregnancy-induced;
Fetal growth restriction;
Risk factors;
Predictive model
- From:
Journal of Chinese Physician
2024;26(7):1042-1045
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To analyze the risk factors for fetal growth restriction (FGR) in late pregnancy of patients with gestational hypertension (HDP) and establish a predictive model.Methods:A retrospective collection of clinical data was conducted on 315 late pregnancy HDP patients at Affiliated Hospital of Jining Medical University from January 2021 to December 2022. The patients were divided into FGR group and non FGR group based on whether FGR occurred. We collected clinical data of HDP patients and used univariate and multivariate logistic regression analysis to evaluate the risk factors for FGR in late pregnancy of HDP patients and establish a prediction model. Hosmer Lemeshow tested the goodness of fit of the model. The receiver operating characteristic (ROC) curve was used to analyze the predictive value of the predictive model for FGR in late pregnancy of HDP patients.Results:The incidence of late pregnancy FGR in 315 patients with HDP was 26.35%(83/315). Univariate analysis showed that the pre pregnancy body mass index (BMI) of the FGR group was lower than that of the non FGR group, and the systolic blood pressure, diastolic blood pressure, umbilical artery pulsatility index (PI), resistance index (RI), and end systolic flow velocity/end diastolic flow velocity ratio (S/D) were higher than those of the non FGR group (all P<0.05). Multivariate logistic regression analysis showed that a decrease in BMI before pregnancy and an increase in systolic blood pressure, diastolic blood pressure, PI, RI, and S/D were independent risk factors for FGR in late pregnancy in HDP patients (all P<0.05). The predictive equation for late pregnancy FGR in HDP patients was y=-4.246+ 0.062×pre-pregnancy BMI+ 0.080×systolic blood pressure+ 0.102×diastolic blood pressure+ 0.716×PI+ 1.200×RI+ 0.382×S/D. The Hosmer Lemeshow test showed P>0.05, indicating a good goodness of Fit. The ROC curve analysis showed that the area under the curve, sensitivity, and specificity of the model for predicting FGR in late pregnancy of HDP patients were 0.939(95% CI: 0.907-0.963), 86.75%, and 87.07%, respectively. Conclusions:Pre-pregnancy BMI, blood pressure, and umbilical artery blood flow parameters are influencing factors for the occurrence of FGR in late pregnancy in HDP patients. The model established based on these factors has high predictive value for FGR in late pregnancy in HDP patients.
