Logistic Regression-Based Risk Prediction Model for Delivery before 34 Weeks' Gestation after Transcervical McDonald Cervical Cerclage
- VernacularTitle:基于Logistic回归建立经阴道McDonald子宫颈环扎术后孕34周前分娩的风险预测模型
- Author:
Xueli REN
1
;
Zhenyu CHEN
;
Jingli SUN
Author Information
1. 中国人民解放军北部战区总医院中国医科大学研究生联合培养基地,辽宁沈阳 110000
- Publication Type:Journal Article
- Keywords:
Cervical cerclage;
Cervical insufficiency;
Delivery before 34 weeks of pregnancy;
Nomogram mod-el;
Influencing factors
- From:
Journal of Practical Obstetrics and Gynecology
2025;41(5):406-411
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To establish a risk prediction model by analyzing the influencing factors of delivery be-fore 34 weeks' gestatior with singleton pregnancies who underwent transcervical McDonald's cervical cerclage.Methods:Clinical data of 500 pregnant women with singleton pregnancies who underwent McDonald's cervical cerclage in the Department of Obstetrics and Gynecology,Heping Hospital,General Hospital of the People's Lib-eration Army Northern Theater of Operations from January 1,2019 to February 29,2024 were retrospectively ana-lyzed,and were randomly divided into a training set of 350 cases versus a validation set of 150 cases in accord-ance with a 7∶3 randomization.The data in the training set were screened for predictive variables affecting deliv-ery before 34 weeks' gestation after cervical cerclage using univariate combined multivariate Logistic regression,predictive modeling and assessment were established,and internal validation was performed in the validation set.Results:Preoperative cervical length(CL)＜20 mm,amniotic fluid deposits(AFS),absence of Lactobacillus vagi-nalis,and cervical dilatation＞3 cm were independent risk factors for adverse outcomes of labor and delivery be-fore 34 weeks' gestation after cervical cerclage(OR＞1,P＜0.05),and the Nomogram model constructed on the basis of this was found to have an AUC of 0.887,with a good agreement of the model(H-L test:P=0.905,Brier score of 0.095).The results of the clinical decision curve showed that the clinical decision value of the model was high when the threshold was between 0.10-0.92.The model was internally validated with an AUC of 0.812,and there was a high degree of agreement between the predictions and the actual situation(H-L test:P=0.859).Conclusions:The column-line diagram model constructed on this basis has a high clinical value,which can help us to screen out the high-risk pregnant women and give them individualized interventions in a timely manner.
