Kumar Manisha, Ravi V, Meena Deepika, Chopra Kanika, Nain Shilpi, Puri Manju
Department of Obstetrics and Gynecology, Lady Hardinge Medical College, Shahid Bhagat Singh Marg, New Delhi, 110001 India.
Department of Statistics, Lady Sri Ram College, New Delhi, India.
J Obstet Gynaecol India. 2022 Aug;72(Suppl 1):96-101. doi: 10.1007/s13224-021-01561-3. Epub 2021 Sep 20.
To develop a predictive model for late stillbirth among women with hypertensive disorders of pregnancy (HDP) in low- and middle-income countries.
Study was part of the WHO newborn birth defect (NBBD) project and included all stillbirths occurring in the facility from November 2015 to December 2020. The age and parity matched subjects with HDP having live birth were taken as controls. All significant predictors were analyzed and a predictive model was developed.
Out of 69,007 deliveries, 1691(24.5/1000) were stillborn. HDP was seen in (390/1691, 23.0%), in 265/390 (67.4%) cases it occurred at or after 28 weeks of gestation and were included as cases. On comparing the cases with controls, the significant factors were estimated fetal weight less than 2000 gms ( < 0.001, OR 10.3), poor antenatal care ( < 0.001, OR-5.9), family history of hypertension ( < 0.018, OR-4.4) and the presence of gestational hypertension ( = 0.001, OR 2.2). The predictive model had sensitivity and specificity of 80.3% and 70.03%, respectively, the receiver operating curve showed the area under the curve(AUC) in the range of good prediction (0.846).
The predictive model could play a potential role in stillbirth prevention in women with HDP in low- and middle-income countries.
The online version contains supplementary material available at 10.1007/s13224-021-01561-3.
建立中低收入国家妊娠高血压疾病（HDP）女性晚期死产的预测模型。
该研究是世界卫生组织新生儿出生缺陷（NBBD）项目的一部分，纳入了2015年11月至2020年12月在该机构发生的所有死产病例。将年龄和产次匹配的HDP活产受试者作为对照。分析所有显著预测因素并建立预测模型。
在69007例分娩中，1691例（24.5/1000）为死产。HDP患者有390例（1691例中的23.0%），其中265例（390例中的67.4%）发生在妊娠28周及以后，被纳入病例组。将病例组与对照组进行比较，显著因素包括估计胎儿体重小于2000克（<0.001，比值比10.3）、产前护理差（<0.001，比值比-5.9）、高血压家族史（<0.018，比值比-4.4）以及妊娠期高血压的存在（=0.001，比值比2.2）。该预测模型的敏感性和特异性分别为80.3%和70.03%，受试者操作特征曲线显示曲线下面积（AUC）处于良好预测范围内（0.846）。
该预测模型可能在中低收入国家预防HDP女性死产方面发挥潜在作用。
在线版本包含可在10.1007/s13224-021-01561-3获取的补充材料。
