与胎儿出生缺陷发生有关的因素及 Nomogram 模型的构建。

IF 1.7 Q2 PEDIATRICS Pediatric health, medicine and therapeutics Pub Date : 2024-09-09 eCollection Date: 2024-01-01 DOI:10.2147/PHMT.S468176
Xiaoqin Chen, Lifang Lin, Qiuping Zhong, Heming Wu, Zhiyuan Zheng, Baisen Zhang, Liubing Lan
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引用次数: 0

摘要

目的:探讨胎儿出生缺陷(BD)的影响因素,并构建提名图模型:探讨胎儿出生缺陷(BD)的影响因素,并构建提名图模型:方法:将梅州市人民医院2021年9月至2023年9月收治的341例新生儿随机分为建模组(239例)和验证组(102例)。模型组胎儿分为BD组和非BD组。多变量逻辑回归分析了BD的风险因素;R软件构建了一个提名图模型;接收者操作特征曲线(ROC)评估了该模型对BD的判别能力:结果:先天性心脏病、多指畸形/三指畸形、唇裂/腭裂、耳畸形和足畸形是BD的前五大类型,发病率分别为23.81%、20.63%、12.70%、11.11%和7.94%。BD发病率为26.36%(63/239)。在孕产妇年龄、孕龄、不良妊娠史/分娩史、妊娠高血压、孕期不良情绪和叶酸摄入持续时间方面,BD 组和非 BD 组之间存在显著差异(PC 结论:已确定的风险因素包括孕产妇年龄、孕龄、不良妊娠史/分娩史、妊娠高血压、孕期不良情绪和叶酸摄入持续时间:确定的风险因素包括产妇年龄、孕龄、不良妊娠史、妊娠高血压、不良情绪和叶酸摄入时间。提名图模型在评估新生儿 BD 风险方面显示出良好的区分度和一致性。
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Factors related to the occurrence of fetal birth defects and the construction of a Nomogram model.

Objective: To explore the influencing factors of fetal birth defects (BD) and construct a nomogram model.

Methods: A total of 341 newborns admitted to Meizhou people's hospital from September 2021 to September 2023 were randomly grouped into a modeling group (239 cases) and a validation group (102 cases). The modeling group fetuses were separated into BD and non-BD groups. Multivariate logistic regression analyzed risk factors for BD; R software constructed a nomogram model; Receiver operating characteristic (ROC) curve evaluated the model's discrimination for BD.

Results: The top 5 types of BD were congenital heart disease, polydactyly/syndactyly, cleft lip/palate, ear malformation, and foot malformation, with incidence rates of 23.81%, 20.63%, 12.70%, 11.11%, and 7.94%, respectively. BD incidence was 26.36% (63/239). Significant differences between BD and non-BD groups were found in maternal age, gestational age, history of adverse pregnancy/childbirth, gestational hypertension, adverse emotions during pregnancy, and folic acid intake duration (P<0.05). Logistic regression showed maternal age (OR: 4.125), gestational age (OR: 3.066), adverse pregnancy history (OR: 10.628), gestational hypertension (OR: 5.658), adverse emotions (OR: 5.467), and folic acid intake duration (OR: 4.586) were risk factors for BD (P<0.05). The modeling group's ROC AUC was 0.938, calibration curve slope close to 1, H-L test =8.342, P=0.692; external validation AUC was 0.961, calibration slope close to 1, H-L test =7.634, P=0.635.

Conclusion: Identified risk factors include maternal age, gestational age, adverse pregnancy history, gestational hypertension, adverse emotions, and folic acid intake duration. The nomogram model shows good discrimination and consistency for evaluating neonatal BD risk.

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