Monteiro-Santos João, Henriques Teresa, Nunes Inês, Amorim-Costa Célia, Bernardes João, Costa-Santos Cristina
Department of Community Medicine, Information and Health Decision Sciences-MEDCIDS, Faculty of Medicine, University of Porto, 4200-450 Porto, Portugal.
Center for Health Technology and Services Research-CINTESIS, Faculty of Medicine, University of Porto, 4200-450 Porto, Portugal.
Entropy (Basel). 2020 Jan 16;22(1):104. doi: 10.3390/e22010104.
Prediction of labor is of extreme importance in obstetric care to allow for preventive measures, assuring that both baby and mother have the best possible care. In this work, the authors studied how important nonlinear parameters (entropy and compression) can be as labor predictors. Linear features retrieved from the SisPorto system for cardiotocogram analysis and nonlinear measures were used to predict labor in a dataset of 1072 antepartum tracings, at between 30 and 35 weeks of gestation. Two groups were defined: Group A-fetuses whose traces date was less than one or two weeks before labor, and Group B-fetuses whose traces date was at least one or two weeks before labor. Results suggest that, compared with linear features such as decelerations and variability indices, compression improves labor prediction both within one (C-Statistics of 0.728) and two weeks (C-Statistics of 0.704). Moreover, the correlation between compression and long-term variability was significantly different in groups A and B, denoting that compression and heart rate variability look at different information associated with whether the fetus is closer to or further from labor onset. Nonlinear measures, compression in particular, may be useful in improving labor prediction as a complement to other fetal heart rate features.
在产科护理中，分娩预测极为重要，以便采取预防措施，确保母婴都能得到尽可能好的护理。在这项研究中，作者探讨了非线性参数（熵和压缩）作为分娩预测指标的重要性。从用于分析宫缩图的SisPorto系统中提取的线性特征和非线性指标，被用于在一个包含1072例妊娠30至35周产前记录的数据集里预测分娩情况。研究定义了两组：A组为记录时间距离分娩不到一或两周的胎儿，B组为记录时间距离分娩至少一或两周的胎儿。结果表明，与减速和变异性指数等线性特征相比，压缩在分娩前一周（C统计量为0.728）和两周（C统计量为0.704）内均能改善分娩预测。此外，A组和B组中压缩与长期变异性之间的相关性存在显著差异，这表明压缩和心率变异性反映了与胎儿离分娩开始的远近相关的不同信息。非线性指标，尤其是压缩，作为其他胎儿心率特征的补充，可能有助于改善分娩预测。
