Two risk assessment models for predicting white matter injury in extremely preterm infants

被引:1
作者
Song, Shuting [1 ]
Zhu, Zhicheng [1 ]
Zhang, Ke [1 ]
Xiao, Mili [1 ]
Gao, Ruiwei [1 ]
Li, Qingping [2 ]
Chen, Xiao [3 ]
Mei, Hua [4 ]
Zeng, Lingkong [5 ]
Wei, Yi [6 ]
Zhu, Yanpin [7 ]
Nuer, Ya [8 ]
Yang, Ling [9 ]
Li, Wen [10 ]
Li, Ting [11 ]
Ju, Rong [12 ]
Li, Yangfang [13 ]
Jiang, Lian [14 ]
Chen, Chao [1 ]
Zhu, Li [1 ]
机构
[1] Fudan Univ, Natl Childrens Med Ctr, Dept Neonatol, Childrens Hosp, Shanghai, Peoples R China
[2] Southwest Med Univ, Dept Neonatol, Affiliated Hosp, Luzhou, Sichuan, Peoples R China
[3] Nanchang Univ, Affiliated Hosp 1, Dept Neonatol, Nanchang, Jiangxi, Peoples R China
[4] Inner Mongolia Med Univ, Dept Neonatol, Affiliated Hosp, Hohhot, Inner Mongolia, Peoples R China
[5] Hubei Maternal & Child Hlth Hosp, Dept Neonatol, Wuhan, Hubei, Peoples R China
[6] Guangxi Maternal & Child Hlth Hosp, Dept Neonatol, Nanning, Guangxi, Peoples R China
[7] Xinjiang Med Univ, Affiliated Hosp 1, Dept Neonatol, Urumqi, Xinjiang, Peoples R China
[8] Xinjiang Uygur Autonomous Reg Peoples Hosp, Dept Neonatol, Urumqi, Xinjiang, Peoples R China
[9] Hainan Women & Childrens Med Ctr, Dept Neonatol, Haikou, Hainan, Peoples R China
[10] Shandong Univ, Qilu Hosp, Dept Neonatol, Jinan, Shandong, Peoples R China
[11] Hunan Maternal & Child Hlth Care Hosp, Dept Neonatol, Changsha, Hunan, Peoples R China
[12] Chengdu Womens & Childrens Cent Hosp, Dept Neonatol, Chengdu, Sichuan, Peoples R China
[13] Kunming Childrens Hosp, Dept Neonatol, Kunming, Yunnan, Peoples R China
[14] Hebei Med Univ, Hosp 4, Dept Neonatol, Shijiazhuang, Hebei, Peoples R China
基金
中国国家自然科学基金;
关键词
PERIVENTRICULAR LEUKOMALACIA; CEREBRAL-PALSY; BRAIN-INJURY; DAMAGE; CHORIOAMNIONITIS; ASSOCIATION; HYPOTENSION; OUTCOMES; CHILDREN;
D O I
10.1038/s41390-024-03402-1
中图分类号
R72 [儿科学];
学科分类号
100202 ;
摘要
BackgroundExtremely preterm infants (EPIs) are at high-risk of white matter injury (WMI), leading to long-term neurodevelopmental impairments. We aimed to develop nomograms for WMI.MethodsThe study included patients from 31 provinces, spanning ten years. 6074 patients before 2018 were randomly divided into a training and internal validation group (7:3). The external validation group comprised 1492 patients from 2019. Predictors were identified using the least absolute shrinkage and selection operator (LASSO) and multivariable logistic regression and nomograms were constructed. Models' performance was evaluated using receiver operating characteristic (ROC), decision curve analysis (DCA) and calibration curves.ResultsThe prenatal nomogram included multiple gestation, premature rupture of membranes (PROM), chorioamnionitis, prenatal glucocorticoids, hypertensive disorder complicating pregnancy (HDCP) and Apgar 1 min, with area under the curve (AUC) of 0.805, 0.816 and 0.799 in the training, internal validation and external validation group, respectively. Days of mechanical ventilation (MV), shock, patent ductus arteriosus (PDA) ligation, intraventricular hemorrhage (IVH) grade III-IV, septicemia, hypothermia and necrotizing enterocolitis (NEC) stage II-III were identified as postpartum predictors. The AUCs were 0.791, 0.813 and 0.823 in the three groups, respectively. DCA and calibration curves showed good clinical utility and consistency.ConclusionThe two nomograms provide clinicians with precise and efficient tools for prediction of WMI.ImpactThis study is a large-sample multicenter study, spanning 10 years. The two nomograms are convenient for identifying high-risk infants early, allowing for reducing poor prognosis.
引用
收藏
页码:246 / 252
页数:7
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