Department of Obstetrics and Gynecology, Dianshan Lake People's Hospital of Kunshan, No.1288 Xinle Road, Kunshan, Jiangsu, 215300, China.
Department of Urology, Dianshan Lake People's Hospital of Kunshan, No.1288 Xinle Road, Kunshan, Jiangsu, 215300, China.
BMC Womens Health. 2024 Sep 27;24(1):532. doi: 10.1186/s12905-024-03363-x.
Stress urinary incontinence (SUI), the prevalent form of urinary incontinence, significantly impairs women's quality of life. This study aims to create a visual nomogram to estimate the risk of SUI within one year postpartum for early intervention in high-risk Chinese women.
We recruited 1,531 postpartum women who gave birth at two hospitals in Kunshan City from 2021 to 2022. Delivery details were meticulously extracted from the hospitals' medical records system, while one-year postpartum follow-ups were conducted via phone surveys specifically designed to ascertain SUI status. Utilizing data from one hospital as the training set, logistic regression analysis was performed to pinpoint significant factors and subsequently construct the nomogram. To ensure robustness, an independent dataset sourced from the second hospital served as the external validation cohort. The model's performance was rigorously evaluated using calibration plots, ROC curves, AUC values, and DCA curves.
The study population was 1,125 women. The SUI incidence within one year postpartum was 26% (293/1125). According to the regression analysis, height, pre-pregnancy BMI, method of induction, mode of delivery, perineal condition, neonatal weight, SUI during pregnancy, and SUI during the first pregnancy were incorporated into the nomogram. The AUC of the nomogram was 0.829 (95% CI 0.790-0.867), and the external validation set was 0.746 (95% CI 0.689-0.804). Subgroup analysis based on parity showed good discrimination. The calibration curve indicated concordance. The DCA curve showed a significant net benefit.
Drawing from real-world data, we have successfully developed an SUI predictive model tailored for postpartum Chinese women. Upon successful external validation, this model holds immense potential as an effective screening tool for SUI, enabling timely interventions and ultimately may improve women's quality of life.
压力性尿失禁（SUI）是最常见的尿失禁形式，严重影响女性的生活质量。本研究旨在为中国高风险产后女性创建一个可视化诺模图，以预测产后一年内发生 SUI 的风险，从而进行早期干预。
我们招募了 2021 年至 2022 年在昆山市两家医院分娩的 1531 名产后女性。从医院的病历系统中仔细提取分娩细节，通过专门设计的电话调查进行产后一年随访，以确定 SUI 状态。利用一家医院的数据作为训练集，进行逻辑回归分析，确定显著因素，并构建诺模图。为了确保稳健性，使用来自第二家医院的独立数据集作为外部验证队列。使用校准图、ROC 曲线、AUC 值和 DCA 曲线对模型性能进行严格评估。
研究人群为 1125 名女性。产后一年内 SUI 的发生率为 26%（293/1125）。根据回归分析，身高、孕前 BMI、诱导方式、分娩方式、会阴状况、新生儿体重、妊娠期间 SUI 和首次妊娠期间 SUI 纳入诺模图。该诺模图的 AUC 为 0.829（95%CI 0.790-0.867），外部验证集为 0.746（95%CI 0.689-0.804）。基于产次的亚组分析显示出良好的区分度。校准曲线表明一致性。DCA 曲线显示出显著的净收益。
本研究基于真实世界数据，成功开发了针对中国产后女性的 SUI 预测模型。经过外部验证成功后，该模型有望成为 SUI 的有效筛查工具，能够及时进行干预，最终可能提高女性的生活质量。
