Risk-factor model for postpartum hemorrhage after cesarean delivery: a retrospective study based on 3498 patients
Abstract This study aimed to investigate the risk factors of patients with postpartum hemorrhage (PPH) after cesarean delivery (CD) and to develop a risk-factor model for PPH after CD. Patients were selected from seven affiliated medical institutions of Chongqing Medical University from January 1st,...
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| Format: | Article |
| Language: | English |
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Nature Portfolio
2022-12-01
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| Series: | Scientific Reports |
| Online Access: | https://doi.org/10.1038/s41598-022-23636-5 |
| _version_ | 1797977483359813632 |
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| author | Jun Gong Zhi Chen Yi Zhang Yi-yun Liu Jun-cai Pu Chun-yan Xiong Si-wen Gui Xiao-ling He Hui-lai Wang Xiao-gang Zhong |
| author_facet | Jun Gong Zhi Chen Yi Zhang Yi-yun Liu Jun-cai Pu Chun-yan Xiong Si-wen Gui Xiao-ling He Hui-lai Wang Xiao-gang Zhong |
| author_sort | Jun Gong |
| collection | DOAJ |
| description | Abstract This study aimed to investigate the risk factors of patients with postpartum hemorrhage (PPH) after cesarean delivery (CD) and to develop a risk-factor model for PPH after CD. Patients were selected from seven affiliated medical institutions of Chongqing Medical University from January 1st, 2015, to January 1st, 2020. Continuous and categorical variables were obtained from the hospital’s electronic medical record systems. Independent risk factors were identified by univariate analysis, least absolute shrinkage and selection operator and logistic regression. Furthermore, logistic, extreme gradient boosting, random forest, classification and regression trees, as well as an artificial neural network, were used to build the risk-factor model. A total of 701 PPH cases after CD and 2797 cases of CD without PPH met the inclusion criteria. Univariate analysis screened 28 differential indices. Multi-variable analysis screened 10 risk factors, including placenta previa, gestational age, prothrombin time, thrombin time, fibrinogen, anemia before delivery, placenta accreta, uterine atony, placental abruption and pregnancy with uterine fibroids. Areas under the curve by random forest for the training and test sets were 0.957 and 0.893, respectively. The F1 scores in the random forest training and test sets were 0.708. In conclusion, the risk factors for PPH after CD were identified, and a relatively stable risk-factor model was built. |
| first_indexed | 2024-04-11T05:08:42Z |
| format | Article |
| id | doaj.art-89e592edbf4842f28c82c290bc5bc704 |
| institution | Directory Open Access Journal |
| issn | 2045-2322 |
| language | English |
| last_indexed | 2024-04-11T05:08:42Z |
| publishDate | 2022-12-01 |
| publisher | Nature Portfolio |
| record_format | Article |
| series | Scientific Reports |
| spelling | doaj.art-89e592edbf4842f28c82c290bc5bc7042022-12-25T12:11:38ZengNature PortfolioScientific Reports2045-23222022-12-011211910.1038/s41598-022-23636-5Risk-factor model for postpartum hemorrhage after cesarean delivery: a retrospective study based on 3498 patientsJun Gong0Zhi Chen1Yi Zhang2Yi-yun Liu3Jun-cai Pu4Chun-yan Xiong5Si-wen Gui6Xiao-ling He7Hui-lai Wang8Xiao-gang Zhong9Department of Information Center, The University-Town Hospital of Chongqing Medical UniversityDepartment of Obstetrics and Gynecology, The First Affiliated Hospital of Chongqing Medical UniversitySchool of Public Health and Management, Chongqing Medical UniversityNHC Key Laboratory of Diagnosis and Treatment On Brain Functional Diseases, The First Affiliated Hospital of Chongqing Medical UniversityNHC Key Laboratory of Diagnosis and Treatment On Brain Functional Diseases, The First Affiliated Hospital of Chongqing Medical UniversityDepartment of Obstetrics and Gynecology, The University-Town Hospital of Chongqing Medical UniversityNHC Key Laboratory of Diagnosis and Treatment On Brain Functional Diseases, The First Affiliated Hospital of Chongqing Medical UniversityDepartment of Obstetrics and Gynecology, The First Affiliated Hospital of Chongqing Medical UniversityDepartment of Information Center, The University-Town Hospital of Chongqing Medical UniversityMedical Data Science Academy, Chongqing Medical UniversityAbstract This study aimed to investigate the risk factors of patients with postpartum hemorrhage (PPH) after cesarean delivery (CD) and to develop a risk-factor model for PPH after CD. Patients were selected from seven affiliated medical institutions of Chongqing Medical University from January 1st, 2015, to January 1st, 2020. Continuous and categorical variables were obtained from the hospital’s electronic medical record systems. Independent risk factors were identified by univariate analysis, least absolute shrinkage and selection operator and logistic regression. Furthermore, logistic, extreme gradient boosting, random forest, classification and regression trees, as well as an artificial neural network, were used to build the risk-factor model. A total of 701 PPH cases after CD and 2797 cases of CD without PPH met the inclusion criteria. Univariate analysis screened 28 differential indices. Multi-variable analysis screened 10 risk factors, including placenta previa, gestational age, prothrombin time, thrombin time, fibrinogen, anemia before delivery, placenta accreta, uterine atony, placental abruption and pregnancy with uterine fibroids. Areas under the curve by random forest for the training and test sets were 0.957 and 0.893, respectively. The F1 scores in the random forest training and test sets were 0.708. In conclusion, the risk factors for PPH after CD were identified, and a relatively stable risk-factor model was built.https://doi.org/10.1038/s41598-022-23636-5 |
| spellingShingle | Jun Gong Zhi Chen Yi Zhang Yi-yun Liu Jun-cai Pu Chun-yan Xiong Si-wen Gui Xiao-ling He Hui-lai Wang Xiao-gang Zhong Risk-factor model for postpartum hemorrhage after cesarean delivery: a retrospective study based on 3498 patients Scientific Reports |
| title | Risk-factor model for postpartum hemorrhage after cesarean delivery: a retrospective study based on 3498 patients |
| title_full | Risk-factor model for postpartum hemorrhage after cesarean delivery: a retrospective study based on 3498 patients |
| title_fullStr | Risk-factor model for postpartum hemorrhage after cesarean delivery: a retrospective study based on 3498 patients |
| title_full_unstemmed | Risk-factor model for postpartum hemorrhage after cesarean delivery: a retrospective study based on 3498 patients |
| title_short | Risk-factor model for postpartum hemorrhage after cesarean delivery: a retrospective study based on 3498 patients |
| title_sort | risk factor model for postpartum hemorrhage after cesarean delivery a retrospective study based on 3498 patients |
| url | https://doi.org/10.1038/s41598-022-23636-5 |
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