Obstetric Factors and Predictive Models for Adverse Outcomes in Preterm Infants

Li Jie

doi:10.3969/j.issn.1004-5775.2025.09.008

Abstract：Objective:To explore the obstetric factors and predictive models for adverse outcomes in ultra premature infants(EPI).Methods:A retrospective analysis was conducted on a total of 122 postpartum women who were delivered EPI in the First People's Hospital of Wolong District,Nanyang City from July 2016 to June 2023.The incidence of adverse EPI outcomes was statistically analyzed,single factor and logistic multiple factor regression analysis were conducted,and a risk prediction model was built to identify the risk factors for adverse outcomes in EPI.Results:Compared with the non-adverse outcome group,the proportion of women in the adverse outcome group with pre-pregnancy BMI≥28 kg/m2,vaginal delivery,combined with GDM,gestational infection,smoking and drinking history during pregnancy was higher,and the proportion of women in the prenatal use of dexamethasone was lower.The differences were statistically significant(χ2=4.221,6.302,4.313,6.760,7.222,3.949;P<0.05).Logistic regression model showed that pre-pregnancy BMI≥28 kg/m2,vaginal delivery,combined GDM,and gestational infection were independent risk factors for adverse EPI outcomes(OR=3.354,1.920,3.517,3.391;P<0.05).Prenatal use of dexamethasone was a protective factor(OR=0.685,P<0.05).Receiver operating characteristic(ROC)curve showed that the area under the curve,95％CI,sensitivity and specificity of above obstetric factors in predicting adverse outcomes of EPI were 0.832,0.762～0.903,0.798 and 0.687,respectively.Conclusion:There are many obstetric factors that affect the occurrence of adverse outcome of EPI,including maternal BMI before pregnancy,delivery mode,GDM and pregnancy infection,etc.Rational prenatal use of dexamethasone can improve the prognosis of EPI.The obstetric factors above have good predictive value.