Predictive model for spontaneous preterm labor among pregnant women with contractions and intact amniotic membranes
Predictive model for spontaneous preterm labor among pregnant women with contractions and intact amniotic membranes
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DOI：
10.1007/s00404-012-2397-0
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发表时间：
2012-10-01
影响因子：
2.6
通讯作者：
Moron, Antonio Fernandes
中科院分区：
文献类型：
--
作者：
Barbosa de Oliveira, Ricardo Villar;Martins, Marilia da Gloria;Moron, Antonio Fernandes
为了确定一个预测模型，以支持与早产和胎膜完整的妇女的预后有关的决策，我们进行了一项前瞻性的观察性队列研究，对70例妊娠22至34周的孕妇。对已经完成一个胃肠外安胎疗程的妇女进行一次经阴道超声检查。获得宫颈长度测量和宫颈腺体区存在的超声参数。结果变量是早产（< 35周）的发生率。使用单变量逻辑回归模型，首先估计每个自变量的系数。为了构建预测模型，使用包含所有可能与早产相关的选定变量的多变量逻辑回归作为起点。准确性、敏感性、特异性和预测值用于测量预测概率的相关性，并检查模型预测结果的能力。采用Logistic回归模型进行预测分析，计算优势比和95%可信区间，早产发生率为32.80%（23/70）。经验证，所建立的预测模型的准确性为87.88%，敏感性为78.26%，特异性为93.02%，模型预测值与实际值吻合较好，可作为羊膜完整的早产孕妇的预测工具。
To determine a predictive model for supporting decisions relating to the prognosis for women presenting with preterm labor and intact membranes.We conducted a prospective observational cohort study on 70 pregnant women at between 22 and 34 weeks of gestation. Transvaginal sonographic evaluation on the cervix was performed once on women who had completed a course of parenteral tocolysis. The sonographic parameters of cervical length measurement and presence of cervical glandular area were obtained. The outcome variable was occurrences of preterm delivery (< 35 weeks). Using a univariate logistic regression model, the coefficients of each independent variable were first estimated. To construct the predictive model, multivariate logistic regression containing all the selected variables that might be related to preterm delivery was used as the starting point. Accuracy, sensitivity, specificity and predictive values were used to measure associations of predicted probabilities and to check the ability of the model to predict outcomes. The predictive analyses were based on logistic regression models, with calculation of odds ratios and 95 % confidence intervals.The incidence of preterm delivery was 32.80 % (23/70). After validation, the predictive model proposed showed accuracy of 87.88 %, sensitivity of 78.26 % and specificity of 93.02 %.The model presented good accuracy with correspondence between predictions and observations, and has the capacity to become a useful tool for management of pregnant women with preterm labor and intact amniotic membranes.