目前关于先前剖腹产后出生选择的发病率预测因素在预测建模中显示出预测价值较低的预测价值
Merel S F van Hees1, Sander M J van Kuijk2, Dorothea M Koppes1
1Department of Obstetrics and Gynecology, Maastricht University Medical Center+, Maastricht, Netherlands (the); Maastricht University Medical Center+, GROW-School for Oncology and Developmental Biology, Department of Obstetrics and Gynaecology, PO Box 5800, 6202 AZ Maastricht, Netherlands (the).
European journal of obstetrics, gynecology, and reproductive biology
|October 18, 2024
概括
在之前的剖腹产术后,开发对母亲和胎儿发病率的预测模型被证明是不成功的. 这些模型缺乏足够的性能来可靠地预测剖腹产或重复剖腹产后阴道分娩的个人风险.
科学领域:
- 产科和妇科 产科和妇科
- 孕产妇和胎儿医学 孕产妇和胎儿医学
- 生殖健康 生殖健康
背景情况:
- 以前的剖腹产会影响后来的分娩结果.
- 对分娩模式的咨询可以通过个性化疾病风险预测来改进.
- 荷兰的一项以人口为基础的研究旨在开发疾病发病率的预测模型.
研究的目的:
- 开发先前剖腹产的妇女对孕产妇和胎儿发病率的预测模型.
- 为了比较分娩试验和可选重复剖腹产之间的发病风险.
- 为了增强关于交付模式选择的咨询.
主要方法:
- 分析了一组2592名曾经接受过一次剖腹产的妇女.
- 孕产妇的发病率包括产后出血,输血,子宫破裂,ICU入院或死亡.
- 新生儿发病率包括窒息,新生儿重症监护室入院或死亡.
- 后勤回归被用来开发预测模型,通过引导和ROC曲线分析进行验证.
主要成果:
- 孕产妇或胎儿并发症发生在12.7%的病例中.
- 与可选重复剖腹产相比,选择试产的女性的整体发病率更高.
- 开发的预测模型显示性能不足 (ROC曲线下的面积<0.6).
结论:
- 由于表现不佳,无法开发基于荷兰人口的与分娩相关的发病率预测模型.
- 进一步的研究可能将重点放在VBAC的成功率上,以提供关于最安全的交付方式的一般建议.
- 准确预测个体发病风险仍然是一个挑战.
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