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基于母亲特征的第一季度预测模型对不良怀孕结果:系统性审查和元分析

Jacintha C A van Eekhout¹, Ellis C Becking², Peter G Scheffer²

¹Department of Genetics, Erasmus Medical Centre, Rotterdam, The Netherlands.

BJOG : an international journal of obstetrics and gynaecology

|October 25, 2024

概括

诸如子宫前症 (PE) 和妊娠期糖尿病 (GDM) 等不良妊娠结果的第一季度预测模型众多. 然而,大多数模型具有高偏差风险,缺乏足够的验证,限制了它们的临床使用.

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
流行病学流行病学

背景情况:

对不良妊娠结果 (APO) 的早期风险分层对于及时干预至关重要.
APO包括妊娠前症 (PE),妊娠年龄较小的新生儿 (SGA),自发早产 (sPTB) 和妊娠糖尿病 (GDM).

研究的目的:

对APO在第一季度开发的预测模型进行系统审查和元分析.
评估这些模型的性能,验证和偏差风险.

主要方法:

在PubMed数据库进行了系统搜索,截至2024年6月6日.
包括仅基于母亲特征的第一季度预测模型,不包括具有生物化学或超声波标记的模型.
数据提取和偏差风险评估由两位独立审稿人使用PROBAST进行.

主要成果:

包括77篇文章,详细介绍了PE,SGA,sPTB和GDM的91个预测模型.
中位数的AUC有所变化:PE (0.75),SGA (无偶发:0.62;多偶发:0.74),sPTB (无偶发:0.65;多偶发:0.71),以及GDM (0.71).
在94.5%的开发模型中发现了偏差的高风险,只有43.9%的模型经过了内部验证,而49.5%的模型经过了外部验证.

结论:

许多第一季度预测模型存在于APOs.
然而,普遍存在重要的方法限制,包括高偏差风险和不充分的验证.
在广泛采用之前,方法质量和临床实用性评估的改进是必要的.

关键词:

负面的怀孕结果.第一个三个月的孕期.孕期糖尿病孕期糖尿病预测模型预测模型孕前症是什么意思风险分层的风险分层.对于妊娠年龄来说很小的新生儿新生儿这是自发的早产.

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