滨州医学院学报2025，Vol.48Issue(4)：418-423,6.DOI:10.19739/j.cnki.issn1001-9510.2025.04.018
基于孕早期相关指标构建二胎孕妇妊娠期高血压疾病风险预测模型及验证
Development and validation of a risk prediction model for hypertensive disorders of pregnancy in second-trimester pregnant women based on early pregnancy indicators
摘要
Abstract
Objective To identify the risk factors for hypertensive disorders in pregnancy(HDP)among second-time preg-nant women and to construct and validate a nomogram-based risk prediction model to assess its predictive performance.Methods A total of 774 women were selected in their second pregnancy with a gestational age of 11-14 weeks who underwent prenatal ex-aminations in the obstetric outpatient clinics from December 2022 to August 2024.Clinical data and serum indicators of the par-ticipants were collected.The participants were categorized into the HDP group and the control group based on the occurrence of HDP.Multivariate logistic regression analysis was performed to identify factors associated with HDP in second-time pregnant women,and these variables were used to develop a predictive model.The model was internally validated by using the Bootstrap method and evaluated for its predictive performance through the receiver operating characteristic(ROC)curve,calibration curve,and decision curve analysis(DC A).Results Among the 774 second-time pregnant women included in the study,61 developed HDP,with an incidence rate of 7.88％.Logistic regression analysis identified age＞40 years old,pre-pregnancy body mass in-dex(BMI)≥28 kg/m2,history of HDP in the first pregnancy,fasting plasma glucose(FPG)levels,and uric acid levels as significant risk factors for HDP.The nomogram-based predictive model constructed using these factors demonstrated a C-index of 0.912 and an area under the ROC curve(AUC)of 0.888.The calibration curve indicated good agreement between predicted probabilities and actual outcomes,and the decision curve analysis showed a high clinical net benefit within a threshold probability range of 10％to 90％.Conclusion Age＞40 years old,pre-pregnancy BMI≥28 kg/m2,history of HDP in the first pregnan-cy,FPG levels,and uric acid levels are key risk factors for HDP in second-time pregnant women.The predictive model based on these risk factors exhibits high predictive accuracy in forecasting the occurrence of HDP in pregnant women with the second child.关键词
妊娠期高血压疾病/二胎孕妇/危险因素/预测模型/Logistic回归Key words
hypertensive disorder in pregnancy/second-time pregnant woman/risk factor/predictive model/logistic regres-sion分类
医药卫生引用本文复制引用
刘文静,黄凯惠,张杰,孔会芳..基于孕早期相关指标构建二胎孕妇妊娠期高血压疾病风险预测模型及验证[J].滨州医学院学报,2025,48(4):418-423,6.基金项目
滨州医学院附属医院护理科研立项项目(BYFYHL-202204) （BYFYHL-202204）
