Construction and verification of a predictive model for perioperative reflux aspiration in pregnant women with gestational diabetes undergoing caesarean section
10.3969/j.issn.1671-8283.2025.06.002
- VernacularTitle:妊娠期糖尿病产妇围术期反流误吸预测模型的构建与验证
- Author:
Wenjing MAO
1
;
Qian ZHANG
1
Author Information
1. 南京医科大学第一附属医院手术室,江苏 南京,210000
- Publication Type:Journal Article
- Keywords:
gestational diabetes mellitus;
predictive model;
preflux aspiration;
perioperative parturient;
cross-sectional study
- From:
Modern Clinical Nursing
2025;24(6):8-15
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the risk factors of perioperative aspiration to the pregnant women with gestational diabetes mellitus(GDM)and caesarean section,hence to develop a nomogram model for prediction of perioperative aspiration in the pregnant women with caesarean section.Methods A convenience sampling method was used to select a total of 960 pregnant women who had GDM and received caesarean section in our hospital from January 2019 to July 2023.The data obtained from the pregnant women were used as the training set.Further 320 pregnant women who had GDM and received caesarean section in our hospital between August 2023 and December 2024 were assigned as the validation set.Logistic regression was used to analyse the risk factors of perioperative regurgitation and aspiration.A nomogram model of perioperative regurgitation and aspiration for the pregnant women with GDM was established using the R software.The Bootstrap method was adopted to conduct repeated sampling for 1,000 times for model validation.The receiver operating characteristic(ROC)curve and the calibration curve were used to evaluate the reliability and prediction of the model.Results The included predictive variables in the model were:the strict preoperative fasting and water deprivation,general anaesthesia,emergency caesarean section,BMI≥28kg/m2,administration of inhaled anaesthetics,operation time over 1 hour,and administration of prenatal antibiotics.The calibration curves of both the training set and the validation set were found comprehensively consistent with the ideal curve.The areas under the ROC curves of the training set and the validation set were 0.855(95%CI:0.781-0.929)and 0.843(95%CI:0.771-0.915),respectively.Conclusion The predictive variables for perioperative regurgitation and aspiration in the pregnant women with GDM include obesity,strict preoperative fasting and water deprivation,general anaesthesia,emergency caesarean section,administration of inhaled anaesthetics,over 1 hour of operation time and administration of prenatal antibiotics.The nomogram model established in this study has a high accuracy and a high clinical value.
