摘要
目的分析子宫内膜异位症(EMS)不孕女性患者夫精人工授精(AIH)助孕后发生自发性早产(SPB)的相关因素,并构建SPB预测模型,评估其效能。方法选取2019年4月至2020年4月海南省妇女儿童医学中心收治的165例EMS不孕女性患者作为研究对象。记录患者基线资料,均行AIH助孕,统计SPB发生情况并分为SPB组和非SPB组,比较两组基线资料,构建SPB预测模型。结果本研究内165例EMS不孕女性患者完成AIH助孕后,成功妊娠,32例发生SPB,发生率为19.39%;Logistic回归分析结果显示,孕前体重指数(BMI)高、多胎妊娠、孕28周宫缩频率高、AIH前心理应激生活事件量表(LES)评分高是EMS不孕女性患者AIH助孕后发生SPB的风险因子(OR>1,P<0.05);男方精子正常形态率(NSMR)高、孕28周宫颈长度长是EMS不孕女性患者AIH助孕后发生SPB的保护因素(OR<1,P<0.05);拟合方程式为:SPB=1.737×孕前BMI-0.032×NSMR+1.027×多胎妊娠(否=0,是=1)-0.281×孕28周宫颈长度+1.022×孕28周宫缩频率+0.185×AIH前心理应激;绘制受试者工作特征(ROC)曲线发现,SPB预测模型预测EMS不孕女性患者AIH助孕后发生SPB的AUC为0.871,有一定预测价值;SPB预测模型经Hosmer-Lemeshow拟合优度检验P>0.05,模型矫正能力良好,拟合满意。结论 EMS不孕女性患者AIH助孕后发生SPB的相关因素包括孕前BMI、是否多胎妊娠、孕28周宫缩频率、AIH前LES评分、NSMR、孕28周宫颈长度;建立SPB预测模型,对预测EMS不孕女性患者完成AIH助孕后SPB有一定效能。
Objective To analyze the related factors of spontaneous preterm birth(SPB) after artificial insemination by husband(AIH) in infertile women with endometriosis(EMS), and construct a SPB prediction model to evaluate its efficacy. Methods 165 infertile women with EMS treated in Hainan Women and Children Medical Center from April 2019 to April 2020 were selected as the research subjects. All cases underwent AIH assisted pregnancy, and were divided into SPB group and non-SPB group by whether the occurrence of SPB. The baseline data of patients were recorded and compared between the two groups to construct the SPB prediction model. Results Among 165 infertile women with EMS who underwent AIH, 32 cases developed SPB, with an incidence of 19.39%. Logistic regression analysis showed that high prepregnancy body mass index(BMI), multiple pregnancy, high frequency of contractions at 28 weeks of gestation, and high preAIH stress life events scale(LES) score were the risk factors for SPB in EMS infertile women after AIH(OR>1,P<0.05). The higher NSMR of male sperm and the longer length of cervix at 28 weeks of gestation were the protective factors for SPB after AIH(OR<1,P<0.05). The fitting equation was as follows: SPB=1.737× pre-pregnancy BMI-0.032×NSMR+1.027× multiple pregnancy(no=0, yes=1)-0.281×cervical length at 28 weeks of pregnancy +1.022× uterine contraction frequency at 28 weeks of pregnancy +0.185×pre-AIH psychological stress;Receiver operating characteristic(ROC) curve was plotted. The AUC of SPB prediction model for infertile women with EMS after AIH pregnancy was 0.871, which had certain predictive value. According to hosmer-Lemeshow goodness of fit test, the SPB prediction model showed good correction ability and satisfactory fitting, P>0.05. Conclusions The related factors of SPB in infertile women with EMS after AIH included pre-pregnancy BMI, multiple pregnancy, frequency of contractions at 28 weeks of gestation, LES score before AIH, NSMR and cervical length at 28 weeks of gestation. The establishment of
作者
叶林
王德珠
朱霜
陈政红
陈万美
YE Lin;WANG Dezhu;ZHU Shuang;CHEN Zhenghong;CHEN Wanmei(Department of Obstetrics,Hainan Women and Children Medical Center,Haikou 570206,Hainan,China)
出处
《中国性科学》
2021年第11期77-80,共4页
Chinese Journal of Human Sexuality
关键词
子宫内膜异位症
夫精人工授精
自发性早产
Endometriosis
Artificial insemination by husband
Spontaneous preterm birth
