|
|
|
| A Comprehensive Analysis of Risk Factors and Prediction Model Construction for BPD Premature Infants with EOP |
| WANG Li, TAO Songxue, SHEN Wei, et al |
| The First Affiliated Hospital of the University of Science and Technology of China / Anhui Provincial Hospital, Anhui Hefei 230001, China |
|
|
|
|
Abstract Objective: To analyze the risk factors of encephalopathy of prematurity (EOP) in preterm infants with Bronchopulmonary Dysplasia (BPD) and establish a prediction model. Methods: A total of 153 premature infants with BPD admitted to our hospital from July 2015 to July 2021 were retrospectively analyzed and divided into EOP group (47 cases) and non-EOP group (106 cases). General data and maternal data of the two groups were compared. A logistic regression prediction model was constructed and validated. The predictive performance of the logistic regression model was evaluated by drawing the receiver operating characteristic (ROC) curve and calculating the area under the curve (AUC). Results: The incidence of sepsis, maternal gestational hypertension, Apgar score ≤ 3 at 5 minutes and moderate to severe BPD in EOP group was higher than that in non-EOP group , and the cesarean section rate was lower than that in non-EOP group, and the differences were statistically significant (P<0.05). Multivariate logistic regression analysis showed that sepsis, gestational hypertension and Apgar score ≤ 3 at 5 minutes were independent risk factors for EOP, and cesarean section was a protective factor. The C-index of the EOP nomogram model is 0.915 (95% Cl: 0.861, 0.936), and the area under ROC curve (AUC) is 0.765 (95%CI: 0.683, 0.847). The calibration curve shows that the predicted probability of EOP occurrence by the nomogram model is consistent with the actual probability, and the Hosmer Lemeshow test reveals no statistically significant difference (χ2=2.494, P=0.777), indicating a good fit. Conclusion: Avoiding infections, preventing gestational hypertension during pregnancy, improving Apgar scores, and opting for cesarean delivery are important methods for preventing early-onset pneumonia (EOP) in preterm infants with bronchopulmonary dysplasia (BPD). Establishing a nomogram prediction model based on the aforementioned variables can effectively assess the risk level of EOP in patients.
|
|
|
|
|
|
[1] 苏建飞,白雪梅.早产儿脑损伤的危险因素分析[J].中国现代医学杂志,2021,31(18):64-68.
[2] 张可,胡兰,李志华,等.早产儿脑病颅脑磁共振影像学特点分析[J].中华医学杂志,2017,97(17):1299-1302.
[3] Dapaah-Siakwan F,Zambrano R,Luo S,et al.Caspase-1 inhibition attenuates hyperoxia-induced lung and brain injury in neonatal mice[J].Am Respir Cell Mol Biol.2019,61(3):341-354.
[4] Martin M,Smith L,Hofheimer JA,et al.Bronchopulmonary dysplasia and neurobehavioural outcomes at birth and 2 years in infants born before 30 weeks[J].Arch Dis Child Fetal Neonatal Ed,2023,108(2):142-148.
[5] 王陈红,沈晓霞,陈鸣艳,等.不同诊断标准下早产儿支气管肺发育不良诊断及预后分析[J].中华儿科杂志,2020,58(5):381-386.
[6] Prasad JD,Gunn KC,Davidson JO,et al.Anti-inflammatory therapies for treatment of inflammation-related preterm brain injury[J].Int Mol Sci,2021,22(8):4008.
[7] Novak CM,Ozen M,Burd I.Perinatal brain injury:mechanisms,prevention,and outcomes[J].Clin Perinatol,2018,45(2):357-375.
[8] Pan S,Lv Z,Wang R,et al.Sepsis-induced brain dysfunction:pathogenesis,diagnosis,and treatment[J].Oxid Med Cell Longev,2022,24(2022):1328729.
[9] Qi Y,Lin Z,Lu H,et al.The Association between pregnancy-induced hypertension and neonatal cerebral metabolism,hemodynamics,and brain injury as determined by physiological imaging[J].Front Physiol,2022,28(13):756386.
[10] 汪良兵,陈益华,颜文杰,等.早产儿蛛网膜下腔间隙增宽的临床特点及脑容量分析[J].中华新生儿科杂志,2023,38(1):3-7.
[11] 许淑静,陈国洪,孙慧清,等.不同程度支气管肺发育不良早产儿神经系统发育对比研究[J].中华实用诊断与治疗杂志,2019,33(2):139-142. |
|
|
|
2025, Vol. 31 
