Sun Xiaoyuan, Wang Fengmei, Huang Chen, Li Na, Yang Yue
Obstetrics and Gynecology, Civil Aviation General Hospital, Beijing, China.
Medicine (Baltimore). 2025 Aug 15;104(33):e43869. doi: 10.1097/MD.0000000000043869.
Gestational hypertension (GH), a prevalent pregnancy complication, requires early risk identification for timely intervention. This study assesses and compares traditional and placental function factors using multivariable logistic regression, random forest, and support vector machine (SVM) models to predict GH risk. We first compared the baseline information and pregnancy-related characteristics between normal pregnant women and those with GH. Then, we modeled the risk of GH based on traditional factors and placental function factors using multivariable logistic regression, random forest, and SVM combined with SHapley Additive exPlanations values. The predictive performance of each model was assessed using receiver operating characteristic curves. Among the models compared, the multivariable logistic regression model based on traditional factors achieved the highest area under the curve (AUC), demonstrating the best predictive performance. The AUC values for random forest and SVM using traditional factors were 0.730 and 0.732, respectively, but their performance was weaker when using placental function factors, with random forest having the lowest AUC (0.612). Feature importance analysis indicated that baseline systolic blood pressure, diastolic blood pressure, high-risk pregnancy, and family history were key predictive factors among traditional factors, while fasting plasma glucose, triglycerides, and C-reactive protein were the most important among placental function factors. Traditional factors best predicted GH, with logistic regression outperforming machine learning methods. While SVM and random forest showed moderate performance with traditional factors, they were less effective with placental function factors. Logistic regression should remain primary, supplemented by other methods for comprehensive prediction.
妊娠期高血压(GH)是一种常见的妊娠并发症,需要早期风险识别以便及时干预。本研究使用多变量逻辑回归、随机森林和支持向量机(SVM)模型评估并比较传统因素和胎盘功能因素,以预测GH风险。我们首先比较了正常孕妇和GH孕妇之间的基线信息及妊娠相关特征。然后,我们使用多变量逻辑回归、随机森林和SVM结合夏普利值(SHapley Additive exPlanations values),基于传统因素和胎盘功能因素对GH风险进行建模。使用受试者工作特征曲线评估每个模型的预测性能。在比较的模型中,基于传统因素的多变量逻辑回归模型获得了最高的曲线下面积(AUC),显示出最佳的预测性能。使用传统因素时,随机森林和SVM的AUC值分别为0.730和0.732,但使用胎盘功能因素时它们的性能较弱,随机森林的AUC最低(0.612)。特征重要性分析表明,基线收缩压、舒张压、高危妊娠和家族史是传统因素中的关键预测因素,而空腹血糖、甘油三酯和C反应蛋白是胎盘功能因素中最重要的因素。传统因素对GH的预测效果最佳,逻辑回归优于机器学习方法。虽然SVM和随机森林在传统因素方面表现中等,但在胎盘功能因素方面效果较差。逻辑回归应作为主要方法,辅以其他方法进行综合预测。