中国妇幼健康研究2025，Vol.36Issue(5)：45-51,7.DOI:10.3969/j.issn.1673-5293.2025.05.007
基于LASSO回归构建非妊娠期糖尿病孕妇分娩大于胎龄儿的列线图预测模型
Based on LASSO regression,a nomogram prediction model for large for gestational age infants delivered by pregnant women with non-gestational diabetes mellitus was constructed
摘要
Abstract
Objective To explore the risk factors of large for gestational age(LGA)babies in pregnant women with non-gestational diabetes mellitus,and to establish a prediction model to provide a reference for individualized scientific management of pregnancy.Methods A retrospective study was conducted on 1 046 pregnant women with non-gestational diabetes who were registered in the first trimester of pregnancy and had regular prenatal examination at the Lingang Campus of Shanghai Sixth People's Hospital from January 2021 to December 2023,and the general data of pregnant women,blood glucose and lipid results during pregnancy were collected.The study subjects were randomly divided into the training set(n=732 cases)and the internal validation set(n=314 cases)in a 7∶3 ratio.LASSO regression was used to screen the risk factors of LGA in non-gestational diabetes mellitus pregnant women,and a nomogram prediction model was constructed.The receiver operating characteristic(ROC)curve,Hosmer-Lemeshow goodness-of-fit test and Calibration calibration curve were used to evaluate the prediction effect of the nomogram model,and the clinical decision curve was used to predict the clinical net benefit of the model.Results A total of 1 046 pregnant women were collected,including 169 LGA infants and 877 non-LGA infants.The predictive model for LGA included four affecting factors:weight in the third trimester(OR=1.063,95％CI:1.034-1.093,P＜0.001),triglycerides in the first trimester(OR=3.360,95％CI:1.985-5.688,P＜0.001),triglycerides in the third trimester(OR=1.706,95％CI:1.285-2.263,P＜0.001),and high density lipoprotein-cholesterol in the third trimester(OR=0.227,95％CI:0.090-0.568,P=0.002).The area under the receiver operating characteristic curve in the training set and internal validation set were 0.815(95％CI:0.766-0.864)and 0.852(95％CI:0.779-0.925),respectively.The Hosmer-Lemeshow test showed that there was no significant difference between the predicted risk value of the model and the actual observed values(P=0.423 in the training set;P=0.727 in the validation set).The calibration curve and the ideal curve almost coincided.The clinical decision curve of the nomogram model indicated a high clinical utility.Conclusion The proposed prediction model for LGA in non-gestational diabetes mellitus has good prediction effect and clinical application value.关键词
非妊娠期糖尿病/孕妇/大于胎龄儿/危险因素/预测模型/LASSO回归/列线图Key words
non-gestational diabetes mellitus/pregnant woman/large for gestational age infants/risk factors/predictive models/LASSO regression/nomogram分类
预防医学引用本文复制引用
周月娣,陈宇..基于LASSO回归构建非妊娠期糖尿病孕妇分娩大于胎龄儿的列线图预测模型[J].中国妇幼健康研究,2025,36(5):45-51,7.基金项目
上海市第六人民医院院级管理科研基金(lygl202212) （lygl202212）
"市六-临港"紧密型健康联合体临床类科研项目(ynlglht202404) （ynlglht202404）
