Externally validated nomogram for predicting short-term pregnancy outcome of singleton pregnancies with fetal growth restriction (FGR)
Objective This study aimed at developing an available predictive model of singleton pregnancies with fetal growth restriction (FGR) for accurate and individualised prognosis assessment.Methods The prediction nomogram was developed by using multivariable Cox regression with data for 301 singleton FGR...
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| Language: | English |
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BMJ Publishing Group
2024-04-01
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| Series: | Gynecology and Obstetrics Clinical Medicine |
| Online Access: | https://gocm.bmj.com/content/4/1/e000009.full |
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| author | Yang Li Xiaohong Zhang Junshu Xie Fufen Yin Mingrui Jin Yujing Li Xiuju Yin |
| author_facet | Yang Li Xiaohong Zhang Junshu Xie Fufen Yin Mingrui Jin Yujing Li Xiuju Yin |
| author_sort | Yang Li |
| collection | DOAJ |
| description | Objective This study aimed at developing an available predictive model of singleton pregnancies with fetal growth restriction (FGR) for accurate and individualised prognosis assessment.Methods The prediction nomogram was developed by using multivariable Cox regression with data for 301 singleton FGR pregnancies at Peking University People’s Hospital. External validation was performed in 321 eligible singleton FGR pregnancies at the Affiliated Hospital of Qingdao University.Results Absent umbilical arterial flow, fetal anomaly, history of abnormal pregnancy, non-cephalic presentation and history of caesarean section were independent prognostic factors for adverse perinatal outcomes in singleton FGR pregnancies in the training set. In the training cohort of the internal validation set, the nomogram estimated pregnancy prognosis of FGR singleton pregnancies based on these five variables, with a concordance index (C-index) of 0.859 (95% CI: 0.81 to 0.90) for predicting termination of pregnancy (TOP), which included intrauterine fetal death and therapeutic lethal induction, with a C-index of 0.92 (95% CI: 0.86 to 0.98) for predicting stillbirth, and a C-index of 0.87 (95% CI: 0.83 to 0.92) for predicting therapeutic lethal induction with indications. Encouragingly, consistent results were observed in the external validation set, with a C-index of 0.776 (95% CI: 0.71 to 0.84) for predicting TOP, which included intrauterine fetal death and therapeutic lethal induction, with a C-index of 0.773 (95% CI: 0.70 to 0.84) for predicting stillbirth, and a C-index of 0.776 (95% CI: 0.70 to 0.85) for predicting therapeutic lethal induction with indications. Furthermore, the calibrations of the nomograms predicting the 28th and 34th TOP-free gestation week strongly corresponded to the actual survival outcome.Conclusion This prediction model may help clinicians in decision-making for singleton pregnancies with FGR, especially for patients with a single abnormal umbilical arterial flow or fetal anomaly, without induced labour indications for these abnormalities. |
| format | Article |
| id | doaj-art-83676d11ace24b5eb8204ac7c3868ca4 |
| institution | Kabale University |
| issn | 2097-0587 2667-1646 |
| language | English |
| publishDate | 2024-04-01 |
| publisher | BMJ Publishing Group |
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| series | Gynecology and Obstetrics Clinical Medicine |
| spelling | doaj-art-83676d11ace24b5eb8204ac7c3868ca42025-01-19T06:05:09ZengBMJ Publishing GroupGynecology and Obstetrics Clinical Medicine2097-05872667-16462024-04-014110.1136/gocm-2024-000009Externally validated nomogram for predicting short-term pregnancy outcome of singleton pregnancies with fetal growth restriction (FGR)Yang Li0Xiaohong Zhang1Junshu Xie2Fufen Yin3Mingrui Jin4Yujing Li5Xiuju Yin6Interventional Center of Valvular Heart Disease, Beijing Anzhen Hospital Affiliated to Capital Medical University, Beijing, ChinaDepartment of Hematology, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China1 Department of Obstetrics and Gynecology, Peking University People`s Hospital, Beijing, China1 Department of Obstetrics and Gynecology, Peking University People`s Hospital, Beijing, China2 Department of Ophthalmology, Beijing Tongren Eye Center, Capital Medical University, Beijing, China3 Department of Pathology, China Medical University College of Basic Medical Sciences, Shenyang, Liaoning, China1 Department of Obstetrics and Gynecology, Peking University People`s Hospital, Beijing, ChinaObjective This study aimed at developing an available predictive model of singleton pregnancies with fetal growth restriction (FGR) for accurate and individualised prognosis assessment.Methods The prediction nomogram was developed by using multivariable Cox regression with data for 301 singleton FGR pregnancies at Peking University People’s Hospital. External validation was performed in 321 eligible singleton FGR pregnancies at the Affiliated Hospital of Qingdao University.Results Absent umbilical arterial flow, fetal anomaly, history of abnormal pregnancy, non-cephalic presentation and history of caesarean section were independent prognostic factors for adverse perinatal outcomes in singleton FGR pregnancies in the training set. In the training cohort of the internal validation set, the nomogram estimated pregnancy prognosis of FGR singleton pregnancies based on these five variables, with a concordance index (C-index) of 0.859 (95% CI: 0.81 to 0.90) for predicting termination of pregnancy (TOP), which included intrauterine fetal death and therapeutic lethal induction, with a C-index of 0.92 (95% CI: 0.86 to 0.98) for predicting stillbirth, and a C-index of 0.87 (95% CI: 0.83 to 0.92) for predicting therapeutic lethal induction with indications. Encouragingly, consistent results were observed in the external validation set, with a C-index of 0.776 (95% CI: 0.71 to 0.84) for predicting TOP, which included intrauterine fetal death and therapeutic lethal induction, with a C-index of 0.773 (95% CI: 0.70 to 0.84) for predicting stillbirth, and a C-index of 0.776 (95% CI: 0.70 to 0.85) for predicting therapeutic lethal induction with indications. Furthermore, the calibrations of the nomograms predicting the 28th and 34th TOP-free gestation week strongly corresponded to the actual survival outcome.Conclusion This prediction model may help clinicians in decision-making for singleton pregnancies with FGR, especially for patients with a single abnormal umbilical arterial flow or fetal anomaly, without induced labour indications for these abnormalities.https://gocm.bmj.com/content/4/1/e000009.full |
| spellingShingle | Yang Li Xiaohong Zhang Junshu Xie Fufen Yin Mingrui Jin Yujing Li Xiuju Yin Externally validated nomogram for predicting short-term pregnancy outcome of singleton pregnancies with fetal growth restriction (FGR) Gynecology and Obstetrics Clinical Medicine |
| title | Externally validated nomogram for predicting short-term pregnancy outcome of singleton pregnancies with fetal growth restriction (FGR) |
| title_full | Externally validated nomogram for predicting short-term pregnancy outcome of singleton pregnancies with fetal growth restriction (FGR) |
| title_fullStr | Externally validated nomogram for predicting short-term pregnancy outcome of singleton pregnancies with fetal growth restriction (FGR) |
| title_full_unstemmed | Externally validated nomogram for predicting short-term pregnancy outcome of singleton pregnancies with fetal growth restriction (FGR) |
| title_short | Externally validated nomogram for predicting short-term pregnancy outcome of singleton pregnancies with fetal growth restriction (FGR) |
| title_sort | externally validated nomogram for predicting short term pregnancy outcome of singleton pregnancies with fetal growth restriction fgr |
| url | https://gocm.bmj.com/content/4/1/e000009.full |
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