Establishment of a Predictive Model for Induced Abortion Failure in Term Sin-gle Pregnancy Pregnant Women / 实用妇产科杂志

ABSTRACT

Objective:To analyze the influencing factors of failed induction of labor(IOL)in full-term singleton pregnant women,and to establish a prediction model for failed IOL.Methods:This study retrospectively analyzed the clinical data of 1483 pregnant women with full-term singleton of IOL in the Department of Obstetrics and Gy-necology,Heping Branch of General Hospital of Northern War Zone from January 1,2019 to December 31,2019.According to the outcome of IOL,the pregnant women were divided into the successful group(1108 cases)and the failed group(375 cases)of IOL.The influencing factors of failed IOL were screened to establish the prediction model through multivariate Logistic regression analysis.The receiver operating characteristic(ROC)curves and Hosmer-Lemeshow test were used to assess the predictive performance and fitting degree of the model.Results:Multivariate Logistic regression analysis showed that there were risk factors for failed IOL(OR>1,P<0.05),in-cluding elderly primiparous delivery,with no history of vaginal delivery,education level≤12 years,gestational age<40 weeks,pre-pregnancy overweight or obesity,excessive gestational weight gain,height<160 cm,cervical Bishop score before IOL<4 points,neonatal weight≥3750 g,combined IOL,suspected fetal distress,and the time from IOL to onset of labor≥24 hours,and height≥165 cm,IOL with dinoprostol suppositories were protective fac-tors for failed IOL(OR<1,P<0.05).Antepartum factors and antepartum factors combined with intrapartum fac-tors were separately used to establish model for predicting failed IOL.The area under the ROC curve(AUC)were 0.914 and 0.940,and the Youden index were 0.660 and 0.733,respectively.The prediction accuracy were 87.5%and 88.9%,respectively.Conclusions:This study screened the significant influencing factors of failed IOL,providing a theoretical basis for clinical measures to improve the success rate of IOL and constructing a pre-diction model of failed IOL,which is helpful for obstetricians and pregnant women to decide the mode of delivery together,and ensure the safety of mother and baby;on the other hand,it aims to enhance everyone′s awareness of pregnancy health care and improve the vaginal delivery rate.