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| 复发性流产再次妊娠孕妇流产的影响因素分析及预测模型构建 |
| Analysis of influencing factors of abortion in RSA women with re-pregnancy and construction of prediction model |
| 投稿时间：2025-03-18 |
| DOI：10.3969/j.issn.1000-0399.2026.05.014 |
| 中文关键词: 复发性流产 再次妊娠 流产 影响因素 预测模型 |
| 英文关键词: Recurrent spontaneous abortion Re-pregnancy Abortion Influencing factors Prediction model |
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| 中文摘要: |
| 目的 分析复发性流产（RSA）再次妊娠孕妇流产的影响因素，以及构建预测模型。方法 回顾性分析2023年1月至2024年6月石家庄市妇幼保健院收治的172例RSA再次妊娠孕妇的临床资料，根据其妊娠结局分为流产组（n=52）和活产组（n=120），用logistic回归分析筛选RSA再次妊娠孕妇流产的独立危险因素，用R软件绘制列线图，用受试者工作特征（ROC）曲线及曲线下面积（AUC）评估列线图的区分度，用校准曲线、Hosmer-Lemeshow拟合优度检验评价列线图的校准度。结果 172例RSA再次妊娠孕妇共52例（30.23%）流产。Logistic回归分析结果显示，有先兆流产症状（OR=4.616,P=0.001）、有孕早期宫腔积液（OR=8.102,P<0.001）、有生殖道感染（OR=3.771,P=0.006）、患多囊卵巢综合征（PCOS）(OR=7.597,P=0.002)、子宫颈机能不全（CIC）(OR=5.653,P=0.005)是RSA再次妊娠孕妇流产的独立危险因素。ROC的AUC为0.797（95%CI:0.721～0.873）。校准曲线斜率接近1，且Hosmer-Lemeshow拟合优度检验χ2=6.506,P=0.369。结论 有先兆流产症状、有孕早期宫腔积液、有生殖道感染、患PCOS、CIC是RSA再次妊娠孕妇流产的独立危险因素，基于这些因素构建的列线图具有良好的预测能力。 |
| 英文摘要: |
| Objective To analyze the influencing factors of abortion in recurrent spontaneous abortion（RSA） women with repregnancy, and to construct a predictive model. Methods A retrospective analysis was conducted on the clinical data of 172 cases RSA women with re-pregnancy who were admitted to Shijiazhuang Maternal and Child Health hospital from January 2023 to June 2024. Complying with their pregnancy outcomes, they were assigned into abortion group（n=52） and live birth group（n=120）. Logistic regression analysis was used to screen for independent risk factors for abortion in RSA women with re-pregnancy. R software was used to draw column charts. Receiver operating characteristic（ROC） curve, calibration curve, and Hosmer-Lemeshow goodness of fit test were used to evaluate the column chart. Results Among 172 RSA women with re-pregnancy, a total of 52（30.23%） had abortion. Logistic regression analysis showed that the presence of threatened abortion symptoms（OR=4.616, P=0.001）, early pregnancy uterine fluid accumulation（OR=8.102, P<0.001）, reproductive tract infection（OR=3.771, P=0.006）, polycystic ovary syndrome（PCOS）(OR=7.597, P=0.002), and cervical incompetence（CIC）(OR=5.653, P=0.005) were independent risk factors for abortion in RSA women with re-pregnancy. The area under the ROC curve was 0.797（95% CI: 0.721～0.873）. The slope of the calibration curve was close to 1, and the Hosmer-Lemeshow goodness of fit test had a χ2 of 6.506 and a P-value of 0.369. Conclusion The presence of threatened abortion symptoms, early uterine fluid accumulation, reproductive tract infections, PCOS, and CIC are independent risk factors for miscarriage in RSA pregnant women. The column chart constructed based on these factors has good predictive ability. |
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