Predictive value of Creasy's high risk factors score in prediction of threatened premature labor
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摘要: 目的 评价Creasy高危因素评分对先兆早产的预测价值,提高先兆早产的诊断率,降低早产率,提高新生儿出生质量。 方法 选取2016年1—6月于国际和平妇幼保健院行定期产检的孕周28~36+6周的532例孕妇作为研究对象,分别进行Creasy高危因素评分。采用χ2检验比较不同Creasy高危因素评分对先兆早产的诊断价值及保胎成功率,采用t检验比较不同孕周先兆早产和未先兆早产的Creasy高危因素评分,计算不同Creasy高危因素评分的敏感度、特异度、准确度和阳性预测值。 结果 532例孕妇改良Creasy早产因素评分以9~12分所占比重最高,占34.40%(183/532),共有127例发生先兆早产,发生率为23.87%(127/532)。Creasy早产因素评分值为12分时敏感度[88.97%(113/127)]和特异度[83.95%(340/405)]相加之和最大,此时准确度[85.15%(453/532)]和阳性预测值[63.48%(113/178)]也最高,故而将≥12分作为预测先兆早产的临界值。Creasy高危因素评分<12分的保胎成功率为85.71%(12/14),明显高于≥12分孕妇的76.11%(86/113),差异具有统计学意义(P<0.05)。不同孕周内28~29+6(15.24±3.22 vs.7.25±1.84,t=26.633,P<0.001)、30~31+6(16.11±3.51 vs.8.41±1.88,t=23.680,P<0.001)、32~33+6(17.21±3.38 vs.8.68±1.96,t=27.050,P<0.001)和34~36+6周(13.58±3.06 vs.6.35±1.62,t=25.529,P<0.001)的先兆早产的改良Creasy早产因素评分值均明显高于未先兆早产患者,差异均具有统计学意义(P<0.05)。 结论 Creasy早产因素评分值12分可作为预测先兆早产的临界分值。Creasy早产因素评分越高,先兆早产发生率越高,保胎成功率越低。
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关键词:
- 先兆早产 /
- 危险因素 /
- Creasy高危因素评分
Abstract: Objective To discuss the predictive value of Creasy's high risk factors score in prediction of threatened premature labor,in order to improve precursor to the diagnosis of premature birth,decrease the rate of premature birth and improve the quality of birth. Methods We selected 532 pregnant women of 28-36+6 gestational weeks as the research objects from January 2016 to June 2016 in our hospital.All cases were analyzed with Creasy risk factor score.We used χ2 test to compare Creasy risk factor's high risk scores between different gestational weeks,and the incidences of threatened premature labor were compared between with and without threatened premature labor in different gestational weeks by t test,to calculate the sensitivity,specificity,accuracy and positive predictive value of each score. Results Creasy's premature labor scores the highest between 9 to 12 points,accounting for 34.40% (183/542).A total of 127 cases suffered from threatened premature labor,with an incidence rate of 23.87%(127/532).When Creasy's high risk factors scores 12,the sum of sensitivity 88.97%(113/127) and specificity 83.95%(340/405) reaches the maximum.At the same time,the accuracy 85.15%(453/532) and positive predictive value 63.48%(113/178) are the highest.Therefore,we set ≥ 12 points as the critical value to predict threatened premature labor.The rate of pregnancy in patients with<12 Creasy's high risk factors score was 85.71%(12/14),higher than 76.11%(86/113) in those with ≥ 12 scores.The scores in threatened premature labor women were significantly higher than those without in different gestational weeks of 28-29+6(15.24±3.22 vs. 7.25±1.84,t=26.633,P<0.001),30-31+6(16.11±3.51 vs. 8.41±1.88,t=23.680,P<0.001),32-33+6(17.21±3.38 vs. 8.68±1.96,t=27.050,P<0.001) and 34-36+6(13.58±3.06 vs. 6.35±1.62,t=25.529,P<0.001). Conclusion Creasy risk factor score ≥ 12 may predict the occurrence of threatened premature labor effectively.Higher Creasy's high risk factors score leads to higher incidence of threatened premature labor and lower successful rate of pregnancy.
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