{"title":"Prognostic model on pregnancy outcomes for women with recurrent spontaneous abortions treated with cyclosporin A: A single-institution experience","authors":"Ze-Ming Zhang, Na Zhang, Xiao-Fei Wang","doi":"10.1016/j.clinsp.2024.100349","DOIUrl":null,"url":null,"abstract":"<div><h3>Background</h3><p>This study aimed to identify prognostic factors for pregnancy outcomes and construct a prognostic model for pregnancy outcomes in women with Recurrent Spontaneous Abortions (RSA) treated with cyclosporin A.</p></div><div><h3>Methods</h3><p>A total of 154 RSA patients treated with cyclosporin A between October 2016 and October 2018 were retrospectively recruited. Multivariate logistic regression was applied to identify the prognostic factors for pregnancy success in RSA women treated with cyclosporin A. The Receiver Operating Characteristic (ROC) curve was applied to construct prognostic value, and the prognostic performance was assessed using area under the ROC.</p></div><div><h3>Results</h3><p>After adjusting potential confounding factors, the authors noted increased age (OR = 0.771; 95 % CI 0.693‒0.858; <em>p</em> < 0.001) and positive antinuclear antibodies (OR = 0.204; 95 % CI 0.079‒0.526; <em>p</em> = 0.001) were associated with a reduced incidence of pregnancy success, while positive anti-β2 glycoprotein-I-antibody (OR = 21.941; 95 % CI 1.176‒409.281; <em>p =</em> 0.039) was associated with an increased incidence of pregnancy success after treated with cyclosporin A. The AUC of combining these variables for predicting pregnancy failure was 0.809 (95 % CI 0.735‒0.880).</p></div><div><h3>Conclusions</h3><p>This study systematically identified the prognostic factors for pregnancy success in women treated with cyclosporin A, and the constructed prognostic model based on these factors with relatively higher prognostic value. Further large-scale prospective studies should be performed to validate the prognostic value of the constructed model.</p></div>","PeriodicalId":10472,"journal":{"name":"Clinics","volume":null,"pages":null},"PeriodicalIF":2.2000,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1807593224000267/pdfft?md5=2a622b7dd91612194c805cf1d57a1907&pid=1-s2.0-S1807593224000267-main.pdf","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Clinics","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S1807593224000267","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"MEDICINE, GENERAL & INTERNAL","Score":null,"Total":0}
引用次数: 0
Abstract
Background
This study aimed to identify prognostic factors for pregnancy outcomes and construct a prognostic model for pregnancy outcomes in women with Recurrent Spontaneous Abortions (RSA) treated with cyclosporin A.
Methods
A total of 154 RSA patients treated with cyclosporin A between October 2016 and October 2018 were retrospectively recruited. Multivariate logistic regression was applied to identify the prognostic factors for pregnancy success in RSA women treated with cyclosporin A. The Receiver Operating Characteristic (ROC) curve was applied to construct prognostic value, and the prognostic performance was assessed using area under the ROC.
Results
After adjusting potential confounding factors, the authors noted increased age (OR = 0.771; 95 % CI 0.693‒0.858; p < 0.001) and positive antinuclear antibodies (OR = 0.204; 95 % CI 0.079‒0.526; p = 0.001) were associated with a reduced incidence of pregnancy success, while positive anti-β2 glycoprotein-I-antibody (OR = 21.941; 95 % CI 1.176‒409.281; p = 0.039) was associated with an increased incidence of pregnancy success after treated with cyclosporin A. The AUC of combining these variables for predicting pregnancy failure was 0.809 (95 % CI 0.735‒0.880).
Conclusions
This study systematically identified the prognostic factors for pregnancy success in women treated with cyclosporin A, and the constructed prognostic model based on these factors with relatively higher prognostic value. Further large-scale prospective studies should be performed to validate the prognostic value of the constructed model.
背景本研究旨在确定接受环孢素A治疗的复发性自发性流产(RSA)妇女的妊娠结局预后因素,并构建妊娠结局预后模型。方法回顾性招募2016年10月至2018年10月期间接受环孢素A治疗的154例RSA患者。应用多变量逻辑回归确定接受环孢素A治疗的RSA女性妊娠成功的预后因素,应用接收者操作特征曲线(ROC)构建预后值,并使用ROC下面积评估预后性能。结果在调整了潜在的混杂因素后,作者发现年龄增加(OR = 0.771; 95 % CI 0.693-0.858; p < 0.001)和抗核抗体阳性(OR = 0.204; 95 % CI 0.079-0.526; p = 0.001)与妊娠成功率降低有关,而抗β2糖蛋白-I-抗体阳性(OR = 21.941; 95 % CI 1.176-409.281; p = 0.039)与环孢素A治疗后妊娠成功率增加有关。结论 该研究系统地确定了环孢素 A 治疗妇女妊娠成功的预后因素,并根据这些因素构建了具有相对较高预后价值的预后模型。应进一步开展大规模前瞻性研究,以验证所构建模型的预后价值。
期刊介绍:
CLINICS is an electronic journal that publishes peer-reviewed articles in continuous flow, of interest to clinicians and researchers in the medical sciences. CLINICS complies with the policies of funding agencies which request or require deposition of the published articles that they fund into publicly available databases. CLINICS supports the position of the International Committee of Medical Journal Editors (ICMJE) on trial registration.