妊娠期高血压疾病的早期预测模型构建OACSTPCD

Objective:To construct an early prediction model for hypertensive disorders in pregnancy(HDP)based on the results of blood routine and liver and kidney functions at 12～19+6 weeks of pregnancy.Method:858 pregnant women who underwent prenatal care and de-livered at Hefei Maternal and Child Health Hospital from January 2017 to December 2019 were included in the study.Among them,70 cases of gestational hypertension(GH)or preeclampsia(PE)were included in the HDP group,while the remaining 788 cases were included in the non-HDP group.Single factor comparison was conducted between two groups of blood routine and liver and kidney functions.Multivariate logistic regression was used to analyze the risk fac-tors of HDP and establish a predictive model.The regression modeling strategy package in R language software was used to establish a nomogram,and the model effectiveness was evaluated from multiple dimensions.Result:MCHC,PLT,MPV,AST,GGT,UA and Glu were independent risk factors for HDP,MHC was an independent protective factor for HDP.Based on the risk fac-tors screened by logistic regression,a predictive model for HDP was established,and the final formula was:Log(Pi)=-21.353+0.045×MCHC(g/L)+0.009×PLT(109/L)-0.270×MHC(pg)+0.353×MPV(fL)+0.011×AST(IU/L)+0.023×GGT(IU/L)+0.007×UA(μmol/L)+0.096×Glu(mmol/dL).The area under the receiver operating characteristic(ROC)curve(AUC)of this model was 0.762(95%CI:0.703～0.820),with an optimal threshold of 0.096.At this point,the specificity was 0.793,and the sensitivity was 0.571.After internal val-idation using Bootstrap sampling,the AUC was 0.741,the Brier score was 0.068,and the pre-dicted probability of the calibration curve was similar to the actual probability.Conclusion:Multiple indexes in the blood routine and liver and kidney functions at 12～19+6 weeks of preg-nancy are risk factors for HDP.The early nomogram prediction model for HDP constructed in this study has good predictive performance and clinical practical value.