Yang Yanxia, Liu Huifang, Yang Siqi, Huang Qianyi, Chen Shaohui
Department of Ultrasound, The Sixth Affiliated Hospital of Jinan University, Dongguan, China.
Department of Medical Laboratory, The Sixth Affiliated Hospital of Jinan University, Dongguan, China.
Front Med (Lausanne). 2025 Aug 20;12:1598587. doi: 10.3389/fmed.2025.1598587. eCollection 2025.
To explore the predictive value of peak systolic velocity (PSV) ratio, PSV1 and PSV2 of ophthalmic artery Doppler in pregnant women for small for gestational age (SGA) infants and to construct a nomogram prediction model.
A total of 201 pregnant women who visited our hospital from March 2022 to June 2024 were selected as the research subjects, and their clinical data and ophthalmic artery Doppler parameters were collected. The data were randomly divided into a training set ( = 295) and a verification set ( = 126) in a 7:3 ratio. The independent risk factors for SGA were screened by univariate and multivariate Logistic regression analysis, and the nomogram model was constructed. The model calibration degree, prediction efficiency and clinical value were evaluated.
The incidence of SGA in the training and validation sets was 25.42 and 25.31%, respectively. Multivariate Logistic regression analysis showed that PSV ratio of ophthalmic artery, PSV1, PSV2, Pulse index 1 (PI1), PI2, and gestational week were the independent risk factors for SGA (all < 0.05). The C-index of the nomogram model in the training set and the verification set was 0.858 and 0.835, respectively, the area under the ROC curve (AUC) was 0.858 (95% : 0.804-0.912) and 0.835 (95% : 0.734-0.936), and the sensitivity and specificity were 0.887, 0.747 and 0.636 and 0.833, respectively. The calibration curve showed good agreement between the predicted and actual values, respectively, which was good by the Hosmer-Lemeshow test. The analysis of decision curve showed that the model had high clinical application value in the range of threshold probability 0.10-0.80.
The nomogram model based on PSV ratio of ophthalmic artery Doppler, PSV1, and PSV2 has good prediction performance for SGA, and provides a new tool for early clinical recognition of high-risk pregnant women with SGA. However, the accuracy and applicability of the model still need to be further verified in the multi-center large sample study.
探讨孕妇眼动脉多普勒收缩期峰值速度(PSV)比值、PSV1和PSV2对小于胎龄(SGA)儿的预测价值,并构建列线图预测模型。
选取2022年3月至2024年6月来我院就诊的201例孕妇作为研究对象,收集其临床资料及眼动脉多普勒参数。将数据按7∶3比例随机分为训练集(n = 140)和验证集(n = 61)。通过单因素和多因素Logistic回归分析筛选SGA的独立危险因素,并构建列线图模型。对模型的校准度、预测效能及临床价值进行评估。
训练集和验证集SGA的发生率分别为25.42%和25.31%。多因素Logistic回归分析显示,眼动脉PSV比值、PSV1、PSV2、搏动指数1(PI1)、PI2及孕周是SGA的独立危险因素(均P < 0.05)。列线图模型在训练集和验证集的C指数分别为0.858和0.835,ROC曲线下面积(AUC)分别为0.858(95%CI:0.804 - 0.912)和0.835(95%CI:0.734 - 0.936),灵敏度和特异度分别为0.887、0.747和0.636、0.833。校准曲线显示预测值与实际值分别具有良好的一致性,Hosmer-Lemeshow检验结果良好。决策曲线分析显示,该模型在阈值概率0.10 - 0.80范围内具有较高的临床应用价值。
基于眼动脉多普勒PSV比值、PSV1和PSV2构建的列线图模型对SGA具有良好的预测性能,为临床早期识别SGA高危孕妇提供了新工具。但该模型的准确性及适用性仍需在多中心大样本研究中进一步验证。