A nomogram to predict extremely preterm birth in women with singleton pregnancies undergoing cervical cerclage
Objective: To develop a nomogram to predict preterm birth before 28 weeks in pregnant women undergoing cervical cerclage. Study design: We retrospectively studied the medical records on pregnant women who underwent cervical cerclage in January 2016 to September 2020. We developed the model from a de...
| Main Authors: | , , , , , , , |
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| Format: | Article |
| Language: | English |
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Elsevier
2022-10-01
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| Series: | Heliyon |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2405844022020199 |
| _version_ | 1811247904243843072 |
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| author | Min Lv Cheng Chen Liping Qiu Neng Jin Minmin Wang Baihui Zhao Danqing Chen Qiong Luo |
| author_facet | Min Lv Cheng Chen Liping Qiu Neng Jin Minmin Wang Baihui Zhao Danqing Chen Qiong Luo |
| author_sort | Min Lv |
| collection | DOAJ |
| description | Objective: To develop a nomogram to predict preterm birth before 28 weeks in pregnant women undergoing cervical cerclage. Study design: We retrospectively studied the medical records on pregnant women who underwent cervical cerclage in January 2016 to September 2020. We developed the model from a development cohort in Women's Hospital, Zhejiang university, School of medicine, which randomly divided by 7:3 into training cohort for nomogram development, and internal validation cohort to confirm the model's performance. We then tested the nomogram in an external validation cohort over a similar period. The Harrell's C-index, calibration curve, decision curve analyses (DCA) were performed to assess the model. Results: 528 patients formed the development cohort, and 97 patients formed the external validation cohort. The model initially incorporated 10 baseline variables, while 5 variables were estimated in the nomogram at last: history of prior second-trimester loss, use of in-vitro fertilization (IVF), cervical dilation at cerclage, C-reactive protein (CRP) and platelet-lymphocyte ratio (PLR). The nomogram achieved good concordance indexes of 0.82(95%CI 0.77–0.88), 0.80(95%CI 0.72–0.88) and 0.79 (95%CI 0.68–0.90) in the training, internal and external validation cohort, respectively. And the nomogram had well-fitted calibration curves. Decision curve analysis demonstrated that the nomogram was clinically useful. Conclusions: The well-performed nomogram graphically represents the risk factors and a pre-operative predicted model in predicting the risk of preterm birth at <28 weeks in singleton pregnant women undergoing cervical cerclage. The model can provide a useful guide for clinicians and patients in making appropriate clinical decisions. |
| first_indexed | 2024-04-12T15:17:45Z |
| format | Article |
| id | doaj.art-b3a17b9f2d594c2384b2e8a8d94ed791 |
| institution | Directory Open Access Journal |
| issn | 2405-8440 |
| language | English |
| last_indexed | 2024-04-12T15:17:45Z |
| publishDate | 2022-10-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Heliyon |
| spelling | doaj.art-b3a17b9f2d594c2384b2e8a8d94ed7912022-12-22T03:27:34ZengElsevierHeliyon2405-84402022-10-01810e10731A nomogram to predict extremely preterm birth in women with singleton pregnancies undergoing cervical cerclageMin Lv0Cheng Chen1Liping Qiu2Neng Jin3Minmin Wang4Baihui Zhao5Danqing Chen6Qiong Luo7Key Laboratory of Women's Reproductive Health of Zhejiang Province, Women's Hospital, School of Medicine, Zhejiang University, Hangzhou, China; The Key Laboratory of Reproductive Genetics (Zhejiang University), Ministry of Education, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China; Department of Obstetrics, Women's Hospital, School of Medicine, Zhejiang University, Hangzhou, ChinaKey Laboratory of Women's Reproductive Health of Zhejiang Province, Women's Hospital, School of Medicine, Zhejiang University, Hangzhou, China; The Key Laboratory of Reproductive Genetics (Zhejiang University), Ministry of Education, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China; Department of Obstetrics, Women's Hospital, School of Medicine, Zhejiang University, Hangzhou, ChinaDepartment of Obstetrics, Women's Hospital, School of Medicine, Zhejiang University, Hangzhou, China; Department of Obstetrics, Maternal and Child Health Care Hospital, Huzhou, Zhejiang, ChinaKey Laboratory of Women's Reproductive Health of Zhejiang Province, Women's Hospital, School of Medicine, Zhejiang University, Hangzhou, China; The Key Laboratory of Reproductive Genetics (Zhejiang University), Ministry of Education, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China; Department of Obstetrics, Women's Hospital, School of Medicine, Zhejiang University, Hangzhou, ChinaDepartment of Obstetrics, Fuyang People's Hospital, Hangzhou, Zhejiang, ChinaDepartment of Obstetrics, Women's Hospital, School of Medicine, Zhejiang University, Hangzhou, ChinaDepartment of Obstetrics, Women's Hospital, School of Medicine, Zhejiang University, Hangzhou, China; Corresponding author.Key Laboratory of Women's Reproductive Health of Zhejiang Province, Women's Hospital, School of Medicine, Zhejiang University, Hangzhou, China; The Key Laboratory of Reproductive Genetics (Zhejiang University), Ministry of Education, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China; Department of Obstetrics, Women's Hospital, School of Medicine, Zhejiang University, Hangzhou, China; Corresponding author.Objective: To develop a nomogram to predict preterm birth before 28 weeks in pregnant women undergoing cervical cerclage. Study design: We retrospectively studied the medical records on pregnant women who underwent cervical cerclage in January 2016 to September 2020. We developed the model from a development cohort in Women's Hospital, Zhejiang university, School of medicine, which randomly divided by 7:3 into training cohort for nomogram development, and internal validation cohort to confirm the model's performance. We then tested the nomogram in an external validation cohort over a similar period. The Harrell's C-index, calibration curve, decision curve analyses (DCA) were performed to assess the model. Results: 528 patients formed the development cohort, and 97 patients formed the external validation cohort. The model initially incorporated 10 baseline variables, while 5 variables were estimated in the nomogram at last: history of prior second-trimester loss, use of in-vitro fertilization (IVF), cervical dilation at cerclage, C-reactive protein (CRP) and platelet-lymphocyte ratio (PLR). The nomogram achieved good concordance indexes of 0.82(95%CI 0.77–0.88), 0.80(95%CI 0.72–0.88) and 0.79 (95%CI 0.68–0.90) in the training, internal and external validation cohort, respectively. And the nomogram had well-fitted calibration curves. Decision curve analysis demonstrated that the nomogram was clinically useful. Conclusions: The well-performed nomogram graphically represents the risk factors and a pre-operative predicted model in predicting the risk of preterm birth at <28 weeks in singleton pregnant women undergoing cervical cerclage. The model can provide a useful guide for clinicians and patients in making appropriate clinical decisions.http://www.sciencedirect.com/science/article/pii/S2405844022020199Cervical insufficiencyCervical cerclagePrognosisNomogramSingletonIVF |
| spellingShingle | Min Lv Cheng Chen Liping Qiu Neng Jin Minmin Wang Baihui Zhao Danqing Chen Qiong Luo A nomogram to predict extremely preterm birth in women with singleton pregnancies undergoing cervical cerclage Heliyon Cervical insufficiency Cervical cerclage Prognosis Nomogram Singleton IVF |
| title | A nomogram to predict extremely preterm birth in women with singleton pregnancies undergoing cervical cerclage |
| title_full | A nomogram to predict extremely preterm birth in women with singleton pregnancies undergoing cervical cerclage |
| title_fullStr | A nomogram to predict extremely preterm birth in women with singleton pregnancies undergoing cervical cerclage |
| title_full_unstemmed | A nomogram to predict extremely preterm birth in women with singleton pregnancies undergoing cervical cerclage |
| title_short | A nomogram to predict extremely preterm birth in women with singleton pregnancies undergoing cervical cerclage |
| title_sort | nomogram to predict extremely preterm birth in women with singleton pregnancies undergoing cervical cerclage |
| topic | Cervical insufficiency Cervical cerclage Prognosis Nomogram Singleton IVF |
| url | http://www.sciencedirect.com/science/article/pii/S2405844022020199 |
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