[1]陆小娟,张弘*,刘琴,等.球囊宫颈扩张器引产及其影响效果的多因素 Logistic回归分析[J].中国计划生育和妇产科,2017,(12):36-40.
　LU Xiao-juan,ZHANG Hong*,LIU Qin,et al.Multi factor Logistic regression analysis of balloon cervical dilator induced labor and its effect[J].Chinese Journal of Family Planning & Gynecotokology,2017,(12):36-40.
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球囊宫颈扩张器引产及其影响效果的多因素 Logistic回归分析
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《中国计划生育和妇产科》[ISSN:1674-4020/CN:51-1708/R]

卷:
期数:
2017年12期
页码:
36-40
栏目:
论著与临床
出版日期:
2017-12-25

文章信息/Info

Title:
Multi factor Logistic regression analysis of balloon cervical dilator induced labor and its effect
作者:
陆小娟1; 张弘2*; 刘琴1; 刘丽1; 黎渊明1
1. 215300江苏昆山，江苏大学附属昆山医院产科；2. 215000江苏苏州，苏州大学附属第二医院妇产科
Author(s):
LU Xiao-juan1; ZHANG Hong2*; LIU Qin1; LIU Li1; LI Yuan-ming1
1.Department of Obstetric, Kunshan Hospital Affiliated to Jiangsu University，Kunshan Jiangsu 215300,P.R.China；2. Second Affiliated Hospital of Suzhou University，Suzhou Jiangsu 215000，P.R.China
关键词:
球囊宫颈扩张器; 引产; 影响因素; Logistic回归分析
Keywords:
balloon cervical dilator; induction; influence factors; Logistic regression
分类号:
R 714
摘要:
目的探讨一次性球囊宫颈扩张器用于妊娠晚期孕妇引产成功的影响因素，建立预测引产效果的Logistic回归模型。方法回顾性分析2015年8月至2017年2月在江苏大学附属昆山医院产科采用一次性球囊宫颈扩张器进行引产的足月妊娠产妇344例的病历资料，分析年龄、身高、体重、体质量指数（body mass index，BMI）、宫高、腹围、孕龄、宫颈Bishop评分、羊水量、脐带因素、胎先露、孕次、产次、新生儿体重、妊娠期并发症等各项因素，分析引产成功的影响因素，纳入Logistic回归分析。结果采用单因素Logistic回归分析显示：身高、宫颈Bishop评分、胎先露衔接、产次、孕次与引产效果呈正相关；而孕妇体重、BMI、新生儿体重、妊娠期高血压疾病与引产效果呈负相关；由此建立多因素回归分析发现影响引产成功的因素主要有身高、宫颈Bishop评分、胎先露衔接、产次、新生儿体重、妊娠期高血压疾病；绘制曲线下面积为0811，约登指数确定最佳诊断界值0720，根据该界值得出的阳性预测值为887 %，阴性预测值为532 %，灵敏度0732，特异度0765，准确度0741。 结论影响球囊引产成功的主要因素有身高、宫颈Bishop评分、胎先露衔接、产次、新生儿体重、妊娠期高血压疾病，这些指标有助于我们更加客观地评估引产效果，提高引产成功率。
Abstract:
ObjectiveExplore the successful factors of disposable balloon cervical dilator in late pregnancy induction, to establish a predictive effect of induction of labor Logistic regression model. Methods344 cases of women with full-term pregnancy who underwent labor induction with disposable balloon cervical dilators in Kunshan Hospital Affiliated to Jiangsu University from August 2015 to February 2017 were retrospectively analyzed. And pregnancy-related information was collected, such as age, height, weight, body mass index(BMI), fundal height, abdominal circumference, gestational age, cervical Bishop score, amniotic fluid volume, umbilical cord factors, fetal presentation, number of pregnancy, number of labor, neonatal weight, pregnancy complications and other factors, to analyze factors affecting successful labor induction. These factors were included into the Logistic regression analysis. ResultsSingle factor Logistic regression analysis showed that height, cervical Bishop score, fetal cohesion, parity, gravidity were positively correlated with abortion effect; while maternal weight, BMI, neonatal birth weight, pregnancy induced hypertension disease were negatively correlated with abortion effect. Therefore, a multiple factor regression analysis was conducted to find 6 main factors affecting the success of labor induction, such as height, cervical Bishop score, fetal presentation, birth weight, gestational hypertension and pregnancy induced hypertension. Draw the area under the curve was 0811; the Youden index to determine the optimal cutoff value of 0720; According to the boundary value of a positive predictive value was 887 %; the negative predictive value was 532 %; The sensitivity was 0732, specificity 0765, accuracy 0741. ConclusionThe main factors that affect the success of balloon induction are height, cervical Bishop score, fetal cohesion, parity, birth weight and gestational hypertension, which can help us make a more objective assessment of the effect of labor induction and improve the success rate of labor induction.

参考文献/References:

［1］VELLEKOOP J, VROUENRAETS F P, VAN DER STEEG J W, et al Indications and results of labour induction in nulliparous women: an interview among obstetricians, residents and clinical midwives ［J］. European Journal of Obstetrics & Gynecology and Reproductive Biology, 2009, 146 (2): 156-159. ［2］中华医学会妇产科学分会产科学组．赵三存,董悦.妊娠晚期促宫颈成熟与引产指南(草案) ［J］．中华妇产科杂志，2008，43（1）：75-76． ［3］张力，刘兴会，卫蔷，等．双球囊导管在足月妊娠促宫颈成熟和引产中的应用 ［J］．四川大学学报(医学版)，2013，44（3）：497-501． ［4］滕奔琦，李晓芸，顾菁，等．影响双球囊引产成功的多因素Logistic回归分析 ［J］．中山大学学报(医学科学版)，2012，33（5）：697-700． ［5］董晓超，徐宁，王志华．子宫颈扩张球囊引产效果影响因素与预测模型研究 ［J］．中国实用妇科与产科杂志，2016，32（10）：990-993． ［6］SCISCIONE A C. Methods of cervical ripening and labor induction: mechanical ［J］. Clinical Obstetrics and Gynecology, 2014, 57(2): 369-376. ［7］JOZWIAK M, BLOEMENKAMP K W, KELLY A J, et al. Mechanical methods for induction of labour ［J］. The Cochrane Database of Systematic Reviews, 2012, 3(3): CD001233. ［8］郑剑兰，付景丽，张小琼，等．双球囊导管及0.8 cm控释地诺前列酮栓在促宫颈成熟与引产方面的随机对照 ［J］．中华妇产科杂志，2011，46（8）：610-612． ［9］AL-SHAIKH G K, WAHABI H A, FAYED Amel-a, et al. Factors associated with successful induction of labor ［J］. Saudi Medical Journal, 2012, 33(3): 298-303. ［10］PEVZNER L, RAYBURN W F, RUMNEY P, et al. Factors predicting successful labor induction with dinoprostone and misoprostol vaginal inserts ［J］. Obstetrics and Gynecology, 2009, 114 (2 Pt 1): 261-267. ［11］妊娠晚期母体怀孕特征对成功引产的影响 ［J］.徐州医学院学报，2010，30（1）：55-56. ［12］CRANE J M, WHITE J, MURPHY P, et al. The effect of gestational weight gain by body mass index on maternal and neonatal outcomes ［J］. Journal of Obstetrics and Gynaecology Canada： JOGC, 2009, 31(1): 28-35.

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更新日期/Last Update: 2017-12-25