Analysis of risk factors associated with different degrees of postpartum hemorrhage in patients with pregnancy-induced hypertension and construction of a prediction model using line graph

被引:4
作者
Zhong, Xiwen [1 ]
Zhang, Pingping [1 ,2 ]
机构
[1] Wenzhou Cent Hosp, Dept Gynaecol & Obstet, Wenzhou, Peoples R China
[2] Wenzhou Cent Hosp, Dept Gynaecol & Obstet, 252 Baili East Rd, Wenzhou 325000, Zhejiang, Peoples R China
关键词
Hypertensive disorder complicating pregnancy; postpartum hemorrhage; influencing factors; nomogram; PREECLAMPSIA; NOMOGRAM; WOMEN;
D O I
10.1080/14767058.2023.2239983
中图分类号
R71 [妇产科学];
学科分类号
100211 ;
摘要
Objective This study aims to analyze the risk factors associated with different degrees of postpartum hemorrhage in patients with pregnancy-induced hypertension and construct a prediction model using line graph. Methods The patients who were treated in our hospital for pregnancy-induced hypertension from January 2021 to December 2022 were enrolled as the study subjects. Their clinical data were collected, and the risk factors associated with postpartum hemorrhage in patients with pregnancy-induced hypertension were analyzed by single-factor and multi-factor logistic regression. The nomogram prediction model was constructed and validated internally, and the discrimination and consistency of the model were verified by the ROC curve and calibration graph. Results In this experiment, 125 out of the 482 patients with hypertensive disorder complicating pregnancy experienced different degrees of postpartum hemorrhage, with an incidence of 25.93%. Multivariate Logistic regression analysis showed that patients with severe disease (OR = 2.454), the degree of proteinuria +++ or ++++ (OR = 6.754, 7.206), fetal body mass & GE;4000 g (OR = 5.972), uterine atony (OR = 11.789), abnormal HDL-C (OR = 3.174), abnormal LDL-C (OR = 8.812), and abnormal VEGF (OR = 7.702) had a higher risk of postpartum hemorrhage (p < .05). The risk of postpartum hemorrhage was lower in patients with onset gestational week & GE;28 weeks (OR = 0.158, 0.025) and delivery gestational week & GE;28 weeks (OR = 0.085, 0.152) (p < .05). Columnar line graph models for postpartum hemorrhage in patients with gestational hypertension were constructed based on nine independent risk factors, and the model differentiation (AUC 0.912 and 0.919, respectively) and precision (goodness of fit HL & chi; (2) = 8.441, p = .392, & chi; (2) = 7.741, p = .459) were better in the modeling and validation groups. Conclusion The severity of disease, the gestational week upon onset, the gestational week upon delivery, the degree of proteinuria, systolic blood pressure, diastolic blood pressure, uterine atony, HDL-C, LDL-C, VEGF are factors affecting the incidence of postpartum hemorrhage in patients with hypertensive disorder complicating pregnancy. The prediction model based on the above factors can accurately evaluate the risk of different degrees of postpartum hemorrhage in patients with hypertensive disorder complicating pregnancy.
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页数:9
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共 20 条
[1]   Maternal cardiovascular risk after hypertensive disorder of pregnancy [J].
Arnott, Clare ;
Nelson, Michael ;
Alfaro Ramirez, Maria ;
Hyett, Jon ;
Gale, Marianne ;
Henry, Amanda ;
Celermajer, David S. ;
Taylor, Lee ;
Woodward, Mark .
HEART, 2020, 106 (24) :1927-1933
[2]   FIGO and the International Confederation of Midwives endorse WHO guidelines on prevention and treatment of postpartum hemorrhage [J].
Begum, Ferdousi ;
Beyeza, Jolly ;
Burke, Thomas ;
Evans, Cherrie ;
Hanson, Claudia ;
Lalonde, Andre ;
Meseret, Yodit ;
Oguttu, Monica ;
Varmask, Poonam ;
West, Florence ;
Wright, Alison .
INTERNATIONAL JOURNAL OF GYNECOLOGY & OBSTETRICS, 2022, 158 :6-10
[3]   Nomogram to predict postpartum hemorrhage in cesarean delivery for women with scarred uterus: A retrospective cohort study in China [J].
Chen, Bingnan ;
Zhang, Liyang ;
Wang, Di ;
Li, Jiapo ;
Hou, Yue ;
Yang, Tian ;
Li, Na ;
Qiao, Chong .
JOURNAL OF OBSTETRICS AND GYNAECOLOGY RESEARCH, 2020, 46 (09) :1772-1782
[4]   Oral antihypertensive regimens (nifedipine retard, labetalol, and methyldopa) for management of severe hypertension in pregnancy: an open-label, randomised controlled trial [J].
Easterling, Thomas ;
Mundle, Shuchita ;
Bracken, Hillary ;
Parvekar, Seema ;
Mool, Sulabha ;
Magee, Laura A. ;
von Dadelszen, Peter ;
Shochet, Tara ;
Winikoff, Beverly .
LANCET, 2019, 394 (10203) :1011-1021
[5]   Oxytocin receptor single nucleotide polymorphism predicts atony-related postpartum hemorrhage [J].
Erickson, Elise N. ;
Krol, Kathleen M. ;
Perkeybile, Allison M. ;
Connelly, Jessica J. ;
Myatt, Leslie .
BMC PREGNANCY AND CHILDBIRTH, 2022, 22 (01)
[6]   Per-and polyfluoroalkyl substances exposure during pregnancy and adverse pregnancy and birth outcomes: A systematic review and meta-analysis [J].
Gao, Xuping ;
Ni, Wanze ;
Zhu, Sui ;
Wu, Yanxin ;
Cui, Yunfeng ;
Ma, Junrong ;
Liu, Yanhua ;
Qiao, Jinlong ;
Ye, Yanbin ;
Yang, Pan ;
Liu, Chaoqun ;
Zeng, Fangfang .
ENVIRONMENTAL RESEARCH, 2021, 201
[7]   Is the increase in postpartum hemorrhage after vaginal birth because of altered clinical practice?: A register-based cohort study [J].
Graugaard, Hanne Lonstrup ;
Maimburg, Rikke Damkjaer .
BIRTH-ISSUES IN PERINATAL CARE, 2021, 48 (03) :338-346
[8]   Prediction of hypertension in pregnancy in high risk women using maternal factors and serial placental profile in second and third trimester [J].
Hasija, Aayushi ;
Balyan, Kirti ;
Debnath, Ekta ;
Ravi, V ;
Kumar, Manisha .
PLACENTA, 2021, 104 :236-242
[9]   Acute Hypertensive Response in Patients With Acute Intracerebral Hemorrhage A Narrative Review [J].
Hawkes, Maximiliano A. ;
Rabinstein, Alejandro A. .
NEUROLOGY, 2021, 97 (07) :316-329
[10]   Re: risk scoring system with MRI for intraoperative massive hemorrhage in placenta previa and accreta [J].
Hecht, Elizabeth M. ;
Prince, Martin R. ;
Khoury-Collado, Fady ;
Laifer-Narin, Sherelle L. .
JOURNAL OF MAGNETIC RESONANCE IMAGING, 2020, 51 (03) :959-960