Evaluation of Pregnancy Risks in Women with Subchorionic Hematoma Using Machine Learning Models
Lan Wang1,2,3, Aiping Qin2, Yihua Yang2
1Department of Gynecology, Guilin People's Hospital, Guilin, Guangxi, China.
Summary
Subchorionic hematoma (SCH) significantly increases miscarriage risk. Key factors like HCG levels and hematoma duration impact delivery outcomes, but SCH generally does not predict NICU transfer or birth weight in successful deliveries.
Area of Science:
- Reproductive Medicine
- Maternal-Fetal Medicine
- Clinical Obstetrics
Background:
- Subchorionic hematoma (SCH) is a common finding in early pregnancy with debated effects on pregnancy outcomes.
- Existing research lacks a comprehensive evaluation of SCH-related clinical factors influencing miscarriage, stillbirth, and preterm birth.
- Understanding these factors is crucial for improving management and predicting outcomes in pregnancies with SCH.
Purpose of the Study:
- To systematically evaluate the influence of SCH-related clinical factors on pregnancy outcomes, including miscarriage, stillbirth, and preterm birth.
- To assess the predictive power of clinical indices for delivery type, NICU transfer, gestational age, and birth weight in women with SCH.
- To identify key clinical factors associated with adverse pregnancy outcomes in the presence of SCH.
Main Methods:
- Retrospective data collection from pregnant women with and without SCH, divided into training and testing datasets.
- Application of machine learning classifiers (e.g., XGB) and logistic regression models to analyze clinical indices.
- Evaluation of model performance using ROC and calibration plots to assess prediction accuracy for various pregnancy outcomes.
Main Results:
- Women with SCH exhibited a significantly higher risk of stillbirth or miscarriage (P<0.001), with XGB models achieving an AUC of 0.916.
- Key predictors for delivery outcomes included first positive HCG, hematoma duration, CA125, gestational sac diameter, fibrinogen, and spouse age.
- Clinical indices did not reliably predict NICU transfer (AUCs 0.589-0.629) or preterm/full-term birth (AUCs 0.449-0.503).
Conclusions:
- Subchorionic hematoma is a significant risk factor for miscarriage and stillbirth, particularly in the first trimester.
- Specific clinical factors like HCG levels, hematoma duration, and serum markers are crucial in determining delivery outcomes.
- While SCH impacts miscarriage risk, its clinical indices do not predict NICU admission or significantly affect newborn birth weight.
