Volume 21 Issue 5
May  2023
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Article Navigation >  Chinese Journal of General Practice  > 2023  >  21(5): 833-837
ZHU Ling, PAN Xuekui, WANG Huifeng, MEI Lina. Value of the competing risk model including sonographically estimated mid-gestation fetal weight in predicting pre-eclampsia risk[J]. Chinese Journal of General Practice, 2023, 21(5): 833-837. doi: 10.16766/j.cnki.issn.1674-4152.002995
Citation: ZHU Ling, PAN Xuekui, WANG Huifeng, MEI Lina. Value of the competing risk model including sonographically estimated mid-gestation fetal weight in predicting pre-eclampsia risk[J]. Chinese Journal of General Practice, 2023, 21(5): 833-837. doi: 10.16766/j.cnki.issn.1674-4152.002995
shu

Value of the competing risk model including sonographically estimated mid-gestation fetal weight in predicting pre-eclampsia risk

doi: 10.16766/j.cnki.issn.1674-4152.002995

  • Department of Ultrasound, Huzhou Maternity and Child Health Care Hospital, Huzhou, Zhejiang 313000, China

Funds:

 2022KY1226

  • Received Date: 2022-02-23
    Abstract
  •   Objective  To develop a competing risk model using sonographically estimated mid-gestation fetal weight for predicting pre-eclampsia risk, and to assess the effectiveness of the model.  Methods  A total of 2 234 women from 19+0 to 24+6 weeks of gestation who underwent routine antenatal checks at Huzhou Maternity and Child Health Care Hospital from March 2019 to December 2020 were selected for this study. Demographic characteristics and medical history were recorded, and fetal weight and hemodynamic parameters were estimated by sonography. The incidence of pre-eclampsia was determined by a follow-up till delivery. General data were compared between women with and without pre-eclampsia matched in a 1∶1 ratio using propensity score matching. A competing risk model was used to screen independent risk factors for pre-eclampsia, and the identified risk factors were used to construct a competing risk model for pre-eclampsia, and the predictive performance of the model was analyzed.  Results  Of the 2 234 cases, 63 were lost to follow-up and the remaining 2 171 were finally included, including 86 with pre-eclampsia (pre-eclampsia group). Sixty pairs were successfully matched. Multivariate competing risk analysis showed that the risk of pre-eclampsia was significantly increased in pregnant women with high mean arterial pressure (MAP), peripheral vascular resistance (PVR) and mean uterine artery pulsatility index (UtA-PI, SHR=1.150, 1.102 and 1.168, all P < 0.05), whereas the risk was significantly lower in those with high fetal weight estimated using sonography (SHR=0.110, P < 0.05). The nomogram constructed using risk factors identified by competing-risks regression obtained a C-index of 0.785 in predicting the risk of pre-eclampsia, showing a high concordance between prediction and reality.  Conclusion  High MAP, PVR and UtA-PI are risk factors for pre-eclampsia, whereas high fetal weight at mid-gestation stage estimated by sonography is a protective factor for pre-eclampsia. The competing risk model for predicting the risk of pre-eclampsia by including the four aforementioned factors has a high predictive value and clinical practicality, which will facilitate screening for pre-eclampsia in high-risk groups.

     

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