摘要
Abstract
Objective:To investigate the factors associated with postpartum hemorrhage in low-risk women who deliver vaginally and to construct a postpartum hemorrhage risk prediction model to provide a basis for predicting the risk of postpartum hemorrhage.Methods:429 cases of singleton low-risk women who delivered vaginally without pregnancy complications and comorbidities in the Second Affiliated Hospital of Shantou University Medical College from June 2019 to December 2022 were selected as the study subjects.The study subjects were divided into a training set(331 cases)and a validation set(98 cases)according to the order of inclusion time.In terms of whether postpartum hemorrhage occurred,the training set was divided into the bleeding group(112 cases)and the non-bleeding group(219 cases),and the validation set was divided into the bleeding group(32 cases)and the non-bleeding group(66 cases).The correlates of postpartum hemorrhage were screened by multivariate logistic regression analysis and a nomogram prediction model was constructed.The area under the curve of the receiver operating characteristic(ROC)was used to assess the discrimination of the prediction model.The calibration of the predictive model was assessed using the Hosmer-Lemeshow(HL)goodness-of-fit test and calibration curve.Results:Multivariate logistic regression analysis showed that maternal uterine height(OR=1.326,95%CI:1.179-1.446),prenatal body mass index(OR=1.111,95%CI:1.020-1.211),gestational age(OR=2.128,95%CI:1.167-3.879),duration of third stage of labor(OR=1.072,95%CI:1.022-1.124),and platelet count(OR=0.990,95%CI:0.986-0.996)were correlates of postpartum hemorrhage.The area under the ROC curve of the prediction model constructed from these five factors was 0.786(95%CI:0.732-0.839)in the training set,and the area under the ROC curve was 0.840(95%CI:0.803-0.869)in the validation set.The P value of the HL test for the training set was 0.529,and the P value of the HL test for the validation set was 0.893,and the calibration curves were all close to the ideal curves,which indicated that the predictive model was well discriminated and calibrated.Conclusion:The prediction model constructed in this study has a good ability to predict the risk of postpartum hemorrhage in low-risk women who deliver vaginally.关键词
产后出血/低危产妇/阴道分娩/风险预测Key words
postpartum hemorrhage/low-risk women/vaginal delivery/risk prediction分类
医药卫生
