[1]蔡中兰,邱海清,涂 瑛,等.足月妊娠发生胎儿窘迫的影响因素及列线图模型的构建与验证[J].医学信息,2026,39(10):52-56.[doi:10.3969/j.issn.1006-1959.2026.10.008]
　CAI Zhonglan,QIU Haiqing,TU Ying,et al.Risk Factors for Fetal Distress in Term Pregnancy and the Constructionand Validation of a Nomogram Model[J].Journal of Medical Information,2026,39(10):52-56.[doi:10.3969/j.issn.1006-1959.2026.10.008]
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足月妊娠发生胎儿窘迫的影响因素及列线图模型的构建与验证()

医学信息[ISSN:1006-1959/CN:61-1278/R]

卷:
39卷
期数:
2026年10期
页码:
52-56
栏目:
临床信息学
出版日期:
2026-05-15

文章信息/Info

Title:
Risk Factors for Fetal Distress in Term Pregnancy and the Constructionand Validation of a Nomogram Model
文章编号:
1006-1959（2026）10-0052-05
作者:
蔡中兰; 邱海清; 涂 瑛; 涂 光; 刘瑞生
黎川县人民医院妇产科，江西 黎川 344600
Author(s):
CAI Zhonglan;  QIU Haiqing;  TU Ying;  TU Guang;  LIU Ruisheng
Department of Obstetrics and Gynecology, Lichuan County People′s Hospital, Lichuan 344600, Jiangxi, China
关键词:
足月妊娠; 胎儿窘迫; 列线图模型
Keywords:
Term pregnancy;  fetal distress;  influencing factors;  Nomogram model
分类号:
R714.5
DOI:
10.3969/j.issn.1006-1959.2026.10.008
文献标志码:
A
摘要:
目的 研究足月妊娠发生胎儿窘迫的影响因素，通过逐步回归分析筛选关键变量，建立列线图模型，应用受试者工作特征（ROC）曲线验证模型效能，预防不良妊娠的发生。方法 选取2023年1月-2024年12月在黎川县人民医院住院的958例足月妊娠孕妇为研究对象，按照7∶3的比例将孕妇随机分为建模组（671例）和验证组（287例），采用Logistic回归分析筛选足月妊娠发生胎儿窘迫的独立影响因素，使用R语言构建列线图预测模型，通过ROC曲线对模型进行验证。结果 模型组671例足月妊娠孕妇中50例发生胎儿窘迫，占7.45%，未发生胎儿窘迫621例，占92.55%；影响足月妊娠孕妇发生胎儿窘迫的单因素显示，妊娠期高血压疾病、孕期贫血、胎盘异常、胎膜早破、脐带异常、胎位异常、羊水污染、产程延长均为足月妊娠发生胎儿窘迫的危险因素（P＜0.05）；多因素Logistic回归分析显示，妊娠期高血压、胎盘异常、胎膜早破、脐带异常、胎位异常、羊水污染、产程延长是胎儿窘迫的危险因素（P＜0.05），而OR值较高的因素有胎盘异常、胎位异常以及羊水污染；选取妊娠期高血压、胎盘异常、胎膜早破、脐带异常、胎位异常、羊水污染、孕期贫血、产程延长构建足月妊娠孕妇胎儿窘迫的列线图预测模型，并绘制ROC曲线，结果显示Logit（P）＞18.293时，该模型预测足月妊娠孕妇发生胎儿窘迫发生的AUC=0.972， 95%CI=0.959~0.979，说明模型具有较高的准确性。结论 妊娠期高血压、胎盘异常、胎膜早破、脐带异常、胎位异常、羊水污染、孕期贫血、产程延长为足月妊娠发生胎儿窘迫的独立危险因素，据此构建的预测模型对胎儿窘迫具有较高的预测价值，可为筛选高危人群、制订临床干预策略提供可靠的参考依据。
Abstract:
Objective To investigate the risk factors for fetal distress in term pregnancy, screen key variables through stepwise regression analysis, establish a nomogram model, apply the receiver operating characteristic (ROC) curve to validate the model’s performance, and prevent the occurrence of adverse pregnancy outcomes. Methods A total of 958 term pregnant women hospitalized in Jinxi County People’s Hospital from January 2023 to December 2024 were selected as the study subjects. The pregnant women were randomly divided into a modeling group (671 cases) and a validation group (287 cases) at a ratio of 7∶3. Logistic regression analysis was used to screen for independent risk factors for fetal distress in term pregnancy. A nomogram prediction model was constructed using R language, and the model was validated using the ROC curve. Results Among the 671 term pregnant women in the modeling group, 50 cases had fetal distress, accounting for 7.45%, and 621 cases had no fetal distress, accounting for 92.55%. Univariate analysis of factors influencing fetal distress in term pregnant women indicated that hypertensive disorders of pregnancy, gestational anemia, placental abnormalities, premature rupture of membranes, umbilical cord abnormalities, fetal malpresentation, meconium-stained amniotic fluid, and prolonged Labor were all risk factors for fetal distress in term pregnancy (P<0.05). Multivariate Logistic regression analysis showed that hypertensive disorders of pregnancy, placental abnormalities, premature rupture of membranes, umbilical cord abnormalities, fetal malpresentation, meconium-stained amniotic fluid, and prolonged labor were risk factors for fetal distress (P<0.05), among which placental abnormalities, fetal malpresentation, and meconium-stained amniotic fluid had higher odds ratios (OR). A nomogram prediction model for fetal distress in term pregnant women was constructed incorporating hypertensive disorders of pregnancy, placental abnormalities, premature rupture of membranes, umbilical cord abnormalities, fetal malpresentation, meconium-stained amniotic fluid, gestational anemia, and prolonged labor, the receiver operating characteristic curve was plotted, and the results showed that when Logit(P)>18.293, the area under the curve for predicting fetal distress in term pregnant women was 0.972, 95%CI=0.959-0.979, indicating that the model had high accuracy. Conclusion Hypertensive disorders of pregnancy, placental abnormalities, premature rupture of membranes, umbilical cord abnormalities, fetal malpresentation, meconium-stained amniotic fluid, gestational anemia, and prolonged labor are independent risk factors for fetal distress in term pregnancy. The prediction model constructed based on these factors has high predictive value for fetal distress and can provide a reliable reference for screening high-risk populations and developing clinical intervention strategies.

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更新日期/Last Update: 1900-01-01