过早分娩风险评分系统及其性能:系统性审查
Amaro Ferreira1, João Bernardes2,3,4, Hernâni Gonçalves2,5
1Faculty of Medicine, University of Porto, 4200-319 Porto, Portugal.
Journal of clinical medicine
|July 14, 2023
概括
使用风险评分系统 (RSS) 预测早产 (PTB) 仍然很困难. 这次审查发现,目前PTB的RSS尽管使用了共同的因素,但预测性表现不佳,限制了其临床使用.
科学领域:
- 产科和妇科 产科和妇科
- 围产儿医学 围产儿医学
- 临床风险预测预测
背景情况:
- 预测早产和风险分层是临床上的重大挑战.
- 已经确定了PTB的众多风险因素,导致了各种风险评分系统 (RSS) 的开发.
研究的目的:
- 系统地审查PTB的现有RSS.
- 为了识别这些RSS中使用的变量.
- 评估这些RSS的预测性能.
主要方法:
- 对两个主要数据库进行了系统的搜索.
- 两个作者进行了独立的选和数据提取.
- 包括评估RSS用于PTB预测的研究,还进行了参考列表搜索.
主要成果:
- 审查中包括了56项研究.
- 在RSS中常用的变量包括母亲的年龄,体重,吸烟史,以前的PTB史和宫长度.
- 性能指标差异很大,灵敏度从4.2%到92.0%不等,AUC从0.59到0.95.
结论:
- 目前PTB的RSS在大多数临床场景中显示出预测能力较差.
- 尽管在了解PTB相关变量方面取得了进展,但单一的通用RSS尚未在临床实践中实现.
- 未来的努力应该集中在开发新的RSS,识别新的预测变量,并创建更大的参考数据集.
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