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| Construct of a Nomogram prediction model for the adverse pregnancy outcomes of women with hypertensive disorder complicating pregnancy based on TEG parameters |
| Hangzhou Obstetrics and Gynecology Hospital, Zhejiang Province, 310016 |
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Abstract To establish a Nomogram prediction model for the adverse pregnancy outcomes of pregnant women with hypertensive disorder complicating pregnancy (HDCP) based on TEG parameters. Methods: 110 pregnant women with HDCP who gave birth in hospital from January 2020 to February 2023 were selected for this prospective study. The incidence of the adverse pregnancy outcomes of the women was analyzed. These women were divided into group A (women with normal pregnancy outcomes) and group B (women with adverse pregnancy outcomes). The clinical data of the women was compared between the two groups. A Nomogram prediction model for the adverse pregnancy outcomes of the pregnant women with HDCP was established and verified. Results: In this study, the incidence of the adverse pregnancy outcomes of the pregnant women with HDCP was 37.3% (41/110). The age, the disease degree of HDCP, the delivery gestational weeks, the regularly supplement folic acid during the first trimester of pregnancy, the values of 24h urine protein (24h PRO), the levels of cystatin C (CysC), D dimer (D-D), hypersensitive reactive protein (hs-CRP), soluble vascular endothelial growth factor receptor 1 (sVEGFR 1), platelet activating factor (PAF) and MicrorNA 124 3p (miR 124 3p), the platelet count(PLT), and the values of R Value (R), maximum amplitude MA (MA) and the coagulation index (CI) of the women in group B were significantly different from those of the women in group B (P<0.05). There were 10 predictors that could improve the model performance with the least λ, including the disease degree of HDCP, the D-D level, the hs-CRP level, the sVEGFR 1 level, the PAF level, the PLT, the miR 124 3p level, the R value, the MA value and the CI value, and all of which were the influential factors of the adverse pregnancy outcomes of the women (P<0.05). A Nomogram predictive model for the adverse pregnancy outcomes based on these influencing factors was constructed, and receiver operating characteristic (ROC) curve showed that the area under the curve (AUC) of this model for predicting the adverse pregnancy outcomes of the women with HDCP was 0.911 (95%CI 0.805-0.962), and the predictive sensitivity and specificity of this model for the adverse pregnancy outcomes were 95.3% and 97.3%, and which had showed the good predictive efficacy. Decision curve (DCA) showed that this model had good clinical efficacy in predicting the risk of the adverse pregnancy outcomes of the women with HDCP. Conclusion: R, MA and CI of TEG parameters are the influential factors of the adverse pregnancy outcomes of the women with HDCP. This Nomogram model constructed based on TEG parameters for predicting the adverse pregnancy outcomes of the women with HDCP has good efficacy and clinical application effect.
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