辅助生殖技术新生儿低出生体质量的影响因素回归方程构建研究

Study on the construction of regression equation of influencing factors of low birth weight of neonates with assisted reproductive technology

摘要

目的 研究辅助生殖技术(ART)新生儿低出生体质量的影响因素,并构建其回归方程,分析回归方程对ART新生儿低出生体质量的预测价值。方法 回顾性收集2021年1月-2023年12月四川锦欣西囡妇女儿童医院收治的297例ART孕妇临床资料作为研究对象,根据其新生儿出生体质量将其分为低体质量组(74例)和体质量正常组(223例),采用单因素和多因素分析ART新生儿低出生体质量的影响因素,并构建相关的回归方程,分析其对ART新生儿低出生体质量的预测价值。结果 有人工流产史(OR=1.820,95%CI:1.194~2.774)、合并多囊卵巢综合征(OR=1.925,95%CI:1.065~3.480)、合并妊娠期缺铁性贫血(OR=1.629,95%CI:1.077~2.463)、妊娠高血压疾病(OR=1.677,95%CI:1.042~2.700)、妊娠期肝内胆汁淤积症(OR=1.887,95%CI:1.140~3.123)、胎盘早剥/胎膜早破(OR=1.820,95%CI:1.113~2.977)、分娩孕周<37周(OR=1.611,95%CI:1.276~2.034)均为ART孕妇新生儿低出生体质量的危险因素(P<0.05).回归方程:logit(P)=-9.771+人工流产史×0.599+合并多囊卵巢综合征×0.655+合并妊娠期缺铁性贫血×0.488+合并妊娠高血压疾病×0.517+合并妊娠期肝内胆汁淤积症×0.635+胎盘早剥/胎膜早破×0.599+分娩孕周×0.477.对ART孕妇新生儿低出生体质量的Logistic回归方程进行评价,似然比χ²=134.732,DF=8,P<0.001;Wald χ²=129.42,DF=7,P<0.001.受试者工作特征(ROC)曲线分析显示,当logit(P)>13.10时,曲线下面积(AUC)值、灵敏度、特异度分别为0.886、79.73%、84.75%。结论 ART孕妇新生儿低出生体质量的危险因素包括有人工流产史、合并多囊卵巢综合征、合并妊娠期缺铁性贫血、妊娠高血压疾病、妊娠期肝内胆汁淤积症、胎盘早剥/胎膜早破、分娩孕周<37周,据此构建的回归方程对ART孕妇新生儿低出生体质量具有较好的预测价值.

Abstract

Objective To study the influencing factors of low birth weight of neonates with assisted reproductive technology (ART), and to construct its regression equation, and to analyze the predictive value of regression equation for low birth weight of ART neonates. Methods The clinical data of 297 pregnant women with ART admitted to Sichuan Jinxin Xinnan Women and Children Hospital from January 2021 to December 2023 were retrospectively collected as the research objects. According to the birth weight of their newborns, they were divided into the low birth weight group (74 cases) and the normal birth weight group (223 cases). Univariate and multivariate analysis were used to analyze the influencing factors of low birth weight in ART neonates, and the regression equation was constructed to analyze its predictive value for low birth weight in ART neonates. Results History of induced abortion (OR=1.820, 95%CI: 1.194-2.774), concomitant polycystic ovary syndrome (OR=1.925, 95%CI: 1.065-3.480), concomitant iron deficiency anemia during pregnancy (OR=1.629, 95%CI: 1.077-2.463), gestational hypertension (OR=1.677, 95%CI: 1.042-2.700), intrahepatic cholestasis of pregnancy (OR=1.887, 95%CI: 1.140-3.123), placental abruption/premature rupture of membranes (OR=1.820, 95%CI: 1.113-2.977), gestational age <37 weeks (OR=1.611, 95%CI: 1.276-2.034) were all risk factors for low birth weight in ART pregnant women and newborns (P<0.05). Regression equation: logit(P)=-9.771+history of induced abortion×0.599+combined with polycystic ovary syndrome×0.655+combined with iron deficiency anemia during pregnancy×0.488+combined with gestational hypertension×0.517+combined with intrahepatic cholestasis of pregnancy×0.635+placental abruption/premature rupture of membranes×0.599+gestational age of delivery×0.477. The logistic regression equation of low birth weight of ART pregnant women was evaluated, and the likelihood ratio χ²=134.732, DF=8, P<0.001; Wald χ²=129.42, DF=7, P<0.001. Receiver operating characteristic curve (ROC) analysis showed that when logit(P)>13.10, the area under the curve (AUC), sensitivity, and specificity were 0.886, 79.73%, and 84.75%, respectively. Conclusion The risk factors for low birth weight of neonates in ART pregnant women included history of induced abortion, combined with polycystic ovary syndrome, combined with iron deficiency anemia during pregnancy, gestational hypertension, intrahepatic cholestasis of pregnancy, placental abruption/premature rupture of membranes, and gestational age <37 weeks. The regression equation constructed based on this has a good predictive value for low birth weight of neonates in ART pregnant women.

关键词

辅助生殖技术 / 新生儿 / 低出生体质量 / 影响因素 / 回归方程 / 预测价值

Key words

assisted reproductive technology / neonate / low birth weight / influencing factor / regression equation / predictive value

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基金资助

成都市卫健委医学科研课题计划项目(2021463)