Lv Min, Chen Cheng, Yang Huaqin, Lou Ying, Li Juan, Zhao Baihui, Chen Danqing, Luo Qiong
Key Laboratory of Women's Reproductive Health of Zhejiang Province, School of Medicine, Women's Hospital, Zhejiang University, Hangzhou, China.
The Key Laboratory of Reproductive Genetics (Zhejiang University), Ministry of Education, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China.
Arch Gynecol Obstet. 2024 Aug;310(2):1009-1018. doi: 10.1007/s00404-023-07322-z. Epub 2023 Dec 31.
To develop a nomogram to predict spontaneous preterm birth at < 28 weeks in pregnant women with twin pregnancies.
We retrospectively studied the medical records of twin-pregnancy women with asymptomatic cervical dilation or cervical shortening between December 2015 to February 2022 in two hospitals. Data from one center was used to develop the model and data from the other was used to evaluate the model.
A total of 270 twin pregnancies were enrolled in the study. We incorporated 4 items (cervical length, cervical dilation, C-reactive protein and the use of cerclage) to build the 28-week nomogram with satisfactory discrimination and calibration when applied to the validation sets. The C index for the 28-week nomogram in the development and external cohort was 0.88 (95% CI, 0.84-0.93) and 0.89 (95% CI, 0.80-0.98), respectively. The nomogram reached a sensitivity of 70.70%, specificity of 97.10%, positive predicted value of 95.61% and negative predicted value of 78.77%. Moreover, the decision curve analysis indicated that the nomogram showed positive clinical benefit.
We developed and validated a nomogram with good performance in predicting individual risk of spontaneous preterm birth at < 28 in twin pregnancy.
建立一种列线图，用于预测双胎妊娠孕妇在28周前的自然早产情况。
我们回顾性研究了2015年12月至2022年2月期间在两家医院就诊的有无症状宫颈扩张或宫颈缩短的双胎妊娠妇女的病历。来自一个中心的数据用于建立模型，另一个中心的数据用于评估模型。
本研究共纳入270例双胎妊娠。我们纳入了4项指标（宫颈长度、宫颈扩张、C反应蛋白和宫颈环扎术的使用情况）来构建28周列线图，应用于验证集时具有令人满意的区分度和校准度。在开发队列和外部队列中，28周列线图的C指数分别为0.88（95%CI，0.84 - 0.93）和0.89（95%CI，0.80 - 0.98）。该列线图的灵敏度为70.70%，特异度为97.10%，阳性预测值为95.61%，阴性预测值为78.77%。此外，决策曲线分析表明该列线图具有积极的临床效益。
我们开发并验证了一种列线图，在预测双胎妊娠28周前自然早产的个体风险方面具有良好性能。
