Constriction of a risk prediction model for early miscarriage during subsequent pregnancy in patients with recurrent spontaneous abortion based on autoantibodies and ultrasound endometrial receptivity parameters
10.3760/cma.j.cn431274-20240408-00610
- VernacularTitle:基于自身抗体和超声子宫内膜容受性参数构建复发性流产患者再孕早期流产的风险模型
- Author:
Min CHEN
1
;
Ruihong WANG
1
Author Information
1. 西安大兴医院产科，西安 710002
- Publication Type:Journal Article
- Keywords:
Autoantibodies;
Endometrial receptivity;
Ultrasonography;
Recurrent spontaneous abortion
- From:
Journal of Chinese Physician
2025;27(6):852-857
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To construct and validate a risk prediction model for early miscarriage during subsequent pregnancy in patients with recurrent spontaneous abortion (RSA) based on autoantibodies and ultrasound endometrial receptivity parameters.Methods:A retrospective analysis was performed on the clinical data of 124 RSA patients who became pregnant again and were admitted to the Xi ′an Daxing Hospital from July 2018 to July 2023. According to the occurrence of early miscarriage, the patients were divided into the early miscarriage group (46 cases) and the non-early miscarriage group (78 cases). The influencing factors for the occurrence of early miscarriage in RSA patients were analyzed, and a Nomogram model was constructed to predict the risk of early miscarriage. The area under the receiver operating characteristic (ROC) curve (AUC) was used to analyze the predictive efficacy of the prediction model for early miscarriage in RSA patients during subsequent pregnancy.Results:Univariate analysis showed that the positive rates of anti-β2-glycoprotein 1 antibody (aβ2-GP1), thyroglobulin antibody (TGAb), antisperm antibodies (AsAb), anticardiolipin antibodies (ACA), and the resistance index (RI) in the early miscarriage group were greater than those in the non-early miscarriage group, while the endometrial thickness, endometrial volume, vascularization index (VI), and vascularization flow index (VFI) were less than those in the non-early miscarriage group (all P<0.05). Binary logistic regression analysis showed that positive aβ2-GP1 and positive TGAb were independent risk factors for early miscarriage in RSA patients during subsequent pregnancy, while endometrial thickness, endometrial volume, and VFI were independent protective factors (all P<0.05). The Nomogram prediction model constructed based on the above-mentioned influencing factors was internally validated by the Bootstrap method, showing a C-index of 0.847 (95% CI: 0.765-0.958), and the calibration curve for predicting early miscarriage in RSA patients during subsequent pregnancy was close to the ideal curve ( P>0.05). The results of the ROC curve showed that the sensitivity, specificity, and AUC of the Nomogram model for predicting early miscarriage in RSA patients during subsequent pregnancy were 89.10%, 85.90%, and 0.889 (95% CI: 0.815-0.963), respectively ( P<0.05). Conclusions:The Nomogram prediction model established based on positive aβ2-GP1, positive TGAb, endometrial thickness, endometrial volume, and VFI can effectively evaluate the risk of early miscarriage in RSA patients during subsequent pregnancy.
