| Objective: To collect clinical data of local patients with spontaneous abortion,summarize their clinical characteristics and establish a recurrent miscarriage prediction model,screen individuals with high risk of recurrent miscarriage in the population,and provide theoretical guidance for the prevention of recurrent miscarriage.Method: The general data of 1694 patients with spontaneous abortion admitted to the Department of Obstetrics and Gynecology of the Affiliated Hospital of Yan’an University from January 2014 to October 2021 were retrospectively collected according to the inclusion and exclusion criteria,including age,height,weight,residential address,education level,number of pregnancies,number of deliveries,number of spontaneous abortions,number of induced abortions,combined with fetal chromosomal abnormalities,infectious factors,anatomical factors,endocrine abnormalities,In the first part,the patients were divided into early miscarriage group and late miscarriage group according to their gestational weeks,and the differences in clinical characteristics and causative factors between the two groups were compared.In the second part,all patients were divided into recurrent miscarriage group(number of spontaneous miscarriages ≥3)and non-recurrent miscarriage group(number of spontaneous miscarriages ≤ 2)by combining their previous spontaneous miscarriage history,and were processed using Empower Stats version 4.1 statistical software to compare general information between the two groups,with all variables as independent variables and whether recurrent miscarriages occurred as dependent variables,and LASSO regression was applied to Analysis was performed to screen the predictor variables of the recurrent miscarriage model,and the screened variables were included in the regression model for the construction of the recurrent miscarriage prediction model,and the model was internally validated.Results: 1.In this study,a total of 1694 cases of spontaneous abortion were collected from the Affiliated Hospital of Yan’an University during 8 years,and the overall age fluctuated from 18 to 48 years old,with an average of about 31 years old,among which there were 782 cases of early abortion and 912 cases of late abortion.(P < 0.05),but there was no statistically significant difference in mean age,home address,and induced abortion(P > 0.05);the distribution of causes of 1694 spontaneous abortions such as chromosomal abnormalities,infectious factors,anatomical factors,endocrine abnormalities,autoimmune abnormalities,systemic diseases,scarred uterus,and other factors accounted for 14.17%,12.34%,5.90%,2.30%,and 3.5% of the total number of patients,respectively,5.90%,2.30%,0.53%,10.98%,32.17%,and 2.60%,respectively.When comparing the causative factors of early miscarriage and late miscarriage,it was found that chromosomal abnormalities were significantly more in early miscarriage than late miscarriage;infection factors,endocrine abnormalities and systemic factors were significantly less in early miscarriage than late miscarriage,and the difference between the two groups was statistically significant(P < 0.05);in There was no statistically significant difference between the two groups in anatomical factors,autoimmunity,scarred uterus and other factors(P > 0.05).2.1694 patients had 99 cases in the recurrent miscarriage group and 1595 cases in the non-recurrent miscarriage group,and the general data and univariate analysis were compared between the two groups using statistical software,and LASSO regression analysis was performed to screen the variables,and the results showed that the four factors of age,body mass index,number of pregnancies and number of abortions were significantly lower between the two groups.The four variables of age,body mass index,number of pregnancies and number of abortions were statistically significant(non-zero variable coefficients)and could be used as predictor variables.The model was constructed using the Diagnostic Test and ROC analysis module with the above four variables as independent variables and whether recurrent abortion occurred as the dependent variable,resulting in a logistic regression equation with an AUC of 0.89(95% CI: 0.87,0.92)for the logistic regression model.0.92),with the highest accuracy of 83.0% when the threshold was equal to 0.82,at which point the model sensitivity was 86.0% and specificity 83.0%.The calibration curve showed that there was good agreement between the predicted and actual results of the model,and when the AUC value was greater than 0.75,it indicated that the model had good predictive ability,so the model could be considered to have good discrimination and calibration.Conclusion: 1.spontaneous abortion can occur at all ages and gestational weeks of reproductive age,with the largest number of abortions between 30-34 years old;excluding the proportion of scarred uterus,the most common factor in patients with early abortion is chromosomal abnormality,while the most common factor in patients with late abortion is infection.2.a prediction model for recurrent abortion based on age,body mass index,gestational frequency,and number of abortions in patients with spontaneous abortion.classification performance is high,with good discrimination and calibration,and has some practical value. |
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