在喀麦隆,非洲高风险的分娩患者中预测产周感染
Gabriella D Cozzi1, Yuanfan Ye2, Rahel Mbah3
1Center for Women's Reproductive Health, University of Alabama at Birmingham, Birmingham, AL, USA; Department of Obstetrics and Gynecology, University of Alabama at Birmingham, Birmingham, AL, USA.
European journal of obstetrics, gynecology, and reproductive biology
|December 14, 2023
概括
在高风险分娩患者中,围产部感染的预测模型确定了教育水平,抗生素使用和剖腹产作为关键因素. 这种模型为母亲感染风险提供了适度的预测.
科学领域:
- 产科和妇科 产科和妇科
- 传染病流行病学 传染病流行病学
- 医疗信息学 医疗信息学
背景情况:
- 产前期感染带来了显著的孕产妇发病风险,特别是在高风险劳动人口中.
- 预测模型对于识别有风险的个体和实施有针对性的干预措施至关重要.
- 现有的模型可能无法完全捕捉到像喀麦隆这样的资源有限的环境中感染风险的复杂性.
研究的目的:
- 开发和验证对孕产妇周产儿感染的预测模型.
- 在喀麦隆的高风险分娩患者中识别周产部感染的独立预测因子.
- 评估一个多变量模型对周边感染风险的预测性能.
主要方法:
- 喀麦隆抗生素预防试验 (NCT03248297) 的二次分析,这是一个随机对照试验.
- 包括经过长期分娩或膜破裂的终期怀孕,不包括先前患有膜炎或禁忌的怀孕.
- 开发一个多变量回归模型,并使用接收器运行特征曲线和名ogram构造进行评估.
主要成果:
- 最终的模型包括没有/小学教育,剖腹产,以及医生的裁量权下接受抗生素,作为围产部感染的显著预测因素.
- 该模型表现出适度的预测能力,曲线下的面积 (AUC) 为0.75.
- 一张名图显示,在一个剖腹产分娩,医生指导的抗生素和大学教育的患者中,围产部感染的概率为35%.
结论:
- 教育水平,抗生素指示和剖腹产分娩独立地与高风险的喀麦隆分娩患者的周产部感染风险有关.
- 开发的3因素模型为周围感染提供了适度的预测能力.
- 建议在更大的群体中进一步验证,以确认这些发现并完善预测模型.
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