Wang Q, Yu X J, Liu H X, Wang H B, Sun X L, Wang Jianliu
Department of Obstetrics and Gynecology, Peking University People's Hospital, Key Laboratory of Female Pelvic Floor Disorders of Beijing, Beijing 100044, China.
Office of Academic Research, Peking University People's Hospital, Beijing 100044, China.
Zhonghua Fu Chan Ke Za Zhi. 2022 Jan 25;57(1):32-38. doi: 10.3760/cma.j.cn112141-20210919-00532.
To analyze the risk factors of pelvic organ prolapse (POP) and to establish the prediction model. A study was conducted on the prevalence of POP among 2 247 parturient women at 6 weeks postpartum in Peking University People's Hospital from December 2018 to October 2019, and relevant influencing factors were analyzed to construct a prediction model of early postpartum POP using logsitic regression, which was validated internally. Data from November 2019 to December 2019 (403 parturient women) were collected for external validation of the prediction model. In addition, the obstetrical factors affecting the occurrence of early postpartum POP in 885 primiparas with vaginal delivery (from January 2019 to November 2019) were further discussed. A total of 2 247 cases were included in the modeling group, and 403 cases were included in the external validation data set. POP accounted for 24.3% (545/2 247). Age, parity, body mass index before pregnancy, vaginal delivery and newborn birth weight were negative factors for early postpartum POP (all <0.05). The nomogram was established based on the above factors, and internal and external verification indicated that the model had a good discrimination (C-index were 0.759 and 0.760, respectively). In addition, this study found that age and newborn birth weight were the main causes of early postpartum POP in primiparas with vaginal delivery (=0.044, =0.004). The incidence of early postpartum POP is high. The prediction model of POP constructed in this study could be used to guide clinical practice to a certain extent and give corresponding treatment suggestions to pregnant women scientifically, so as to provide theoretical support for primary prevention.
分析盆腔器官脱垂（POP）的危险因素并建立预测模型。对2018年12月至2019年10月在北京大学人民医院产后6周的2247例产妇中POP的患病率进行研究，分析相关影响因素，采用逻辑回归构建产后早期POP的预测模型并进行内部验证。收集2019年11月至2019年12月的数据（403例产妇）对预测模型进行外部验证。此外，进一步探讨了2019年1月至2019年11月885例阴道分娩初产妇中影响产后早期POP发生的产科因素。建模组共纳入2247例，外部验证数据集纳入403例。POP占24.3%（545/2247）。年龄、产次、孕前体重指数、阴道分娩及新生儿出生体重是产后早期POP的负性因素（均<0.05）。基于上述因素建立列线图，内外部验证表明该模型具有良好的区分度（C指数分别为0.759和0.760）。此外，本研究发现年龄和新生儿出生体重是阴道分娩初产妇产后早期POP的主要原因（P=0.044，P=0.004）。产后早期POP的发生率较高。本研究构建的POP预测模型可在一定程度上指导临床实践，科学地为孕妇提供相应的治疗建议，为一级预防提供理论支持。
