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在引发分娩期间进行剖腹产计算器的外部验证
Claudia J Ibarra1, Rachel L Wiley2, Han-Yang Chen1
1Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, University of Houston Health Science Center at Houston, Houston, TX, USA.
概括
这项研究验证了一种风险计算器,用于预测经过分娩的妇女的剖腹产. 经过验证的计算器准确地预测了CD的可能性和相关的母亲不良结果.
科学领域:
- 产科和妇科
- 产妇和胎儿医学
- 临床预测模型
背景情况:
- 在全球范围内,剖腹产的发生率持续上升.
- 预测工具对于在劳动诱导过程中做出明智决策至关重要.
- 验证现有的风险计算器对于临床实用性至关重要.
研究的目的:
- 为预测剖腹产 (CD) 发布的风险计算器进行外部验证.
- 评估计算器在预测CD和母亲和新生儿不良结果方面的表现.
- 评估预测的CD风险得分与实际结果之间的关联.
主要方法:
- 单身婴儿进行劳动诱导的回顾性队列研究.
- 外部验证使用接收器操作特征曲线 (AUC) 和校准曲线下的面积.
- 多变量波桑回归计算CD和复合不良结果的调整相对风险 (aRR).
主要成果:
- 风险计算器显示出良好的分辨能力 (AUC = 0.77) 和校准.
- 预测的CD得分较高与CD发生可能性的增加显著相关 (aRR为2. 65- 5. 73).
- 较高的分数也与较高的母体组合不良结果风险相关 (aR 1. 64-1. 81).
结论:
- 验证的预测模型显示了预测剖腹产的良好的外部有效性.
- 预测的剖腹产风险得分较高与剖腹产和产妇并发症的几率增加有关.
- 这种工具可以帮助临床决策引发分娩.
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