Predicting fetal distress and admission to neonatal intensive care unit
in patients with fetal growth restriction by nomogram: A retrospective
cohort study in China
Abstract
Objective: The purpose of this research was to establish prediction
model of fetal distress risk and admission to neonatal intensive care
unit(NICU) risk of patients with fetal growth restriction(FGR). Design:
Case-control study, a retrospective analysis. Setting: Women’s Hospital,
School of Medicine, Zhejiang University in China. Population: 930
patients who were diagnosed with FGR were selected, and using fetal
distress and admission to NICU as outcome.. Methods: Using lasso
regression and multivariable logistic regression analysis established
the nomogram prediction model of fetal distress risk and admission to
NICU risk. Discrimination, calibration and clinical usability of the
predicting model were respectively adopted. Internal validation was
assessed using the bootstrapping validation. Main Outcome Measures:
Nomograms were established for Predicting fetal distress and admission
to neonatal intensive care unit in patients with FGR. Results: We found
that six identified factors associated with fetal distress of patients
with FGR. Four independent predictors were selected for admission to
NICU of patients with FGR. The delivery method of cesarean section
increased the above risks. Two nomograms were developed and verified
accordingly. The two models had good discrimination and good calibration
respectively. The decision curve analysis performed that the clinical
usability and benefits of the nomograms were the range of 3%-75% and
17%-95%. Conclusion: Two nomograms were the first to predict fetal
distress and admission to NICU of patients with FGR. Establishing
effective predictive models based on independent predictors could help
early diagnosis and evaluation of fetal distress and admission to NICU
in patients with FGR.