通讯作者: 尹绪爱, yxachaohu@126.com

DOI：10.12201/bmr.202611.00012

Combined Predictive Value of Clinical, Ultrasonographic, and Inflammation-Related Indicators for the Risk of Cesarean Delivery Among Women With Gestational Diabetes Mellitus

• 摘要：目的 探讨妊娠期糖尿病（gestational diabetes mellitus，GDM）孕妇剖宫产发生的相关因素，并评价临床、超声及炎症相关指标联合对剖宫产发生风险的预测价值。方法 本研究为单中心回顾性队列研究，回顾性分析2021年1月至2024年12月安徽医科大学第四附属医院住院分娩的GDM孕妇673例，根据分娩方式分为剖宫产组（n=349）与顺产组（n=324）。比较2组孕妇的一般临床资料、超声指标及外周血炎症相关指标的差异，采用二分类Logistic回归分析及受试者操作特征曲线评估相关指标及联合模型对剖宫产的预测价值。采用Bootstrap法进行内部验证，评价校正后的区分度及校准度。结果 二分类Logistic回归分析显示年龄、腹围、羊水最大深径及血小板/淋巴细胞比值（platelet-to-lymphocyte ratio，PLR）均是GDM孕妇剖宫产的独立影响因素（P<0.05）。4项指标联合可预测GDM孕妇剖宫产的发生，曲线下面积（area under the curve，AUC）为0.751，敏感度为66.5%，特异性为71.3%。经Bootstrap内部验证，联合模型校正后的AUC为0.736，校准截距为0.003，校准斜率为0.927。结论 年龄、腹围、羊水最大深径及PLR升高与GDM孕妇剖宫产发生独立相关，4项指标联合对GDM孕妇剖宫产发生风险具有一定的预测价值。

  关键词： 妊娠期糖尿病; 剖宫产; 血小板/淋巴细胞比值; 羊水最大深径

   

  Abstract: Objective To investigate factors associated with cesarean delivery in women with gestational diabetes mellitus (GDM) and evaluate the combined the predictive value of clinical, ultrasonographic, and inflammation-related indicators for the risk of cesarean delivery. Methods This was a single-center retrospective cohort study. A total of 673 women with GDM who delivered at the Fourth Affiliated Hospital of Anhui Medical University between January 2021 and December 2024 were retrospectively analyzed. According to the mode of delivery, they were divided into the cesarean delivery group (n=349) and the vaginal delivery group (n=324). General clinical characteristics, ultrasonographic parameters, and peripheral blood inflammation-related indicators were compared between the two groups. Binary logistic regression analysis and receiver operating characteristic (ROC) curve analysis were performed to evaluate the predictive value of the associated indicators and their combination for cesarean delivery. Internal validation was performed using bootstrap resamples to assess optimism-corrected discrimination and calibration. Results Binary logistic regression analysis showed that maternal age, abdominal circumference, maximum vertical pocket of amniotic fluid, and platelet-to-lymphocyte ratio (PLR) were independent factors associated with cesarean delivery in women with GDM (P<0.05). The combination of these four indicators predicted cesarean delivery with an area under the ROC curve (AUC) of 0.751, a sensitivity of 66.5%, and a specificity of 71.3%. After bootstrap internal validation, the optimism-corrected AUC was 0.736, with a calibration intercept of 0.003 and a calibration slope of 0.927. Conclusion Increased maternal age, abdominal circumference, maximum vertical pocket of amniotic fluid, and PLR were independently associated with cesarean delivery in women with GDM. These four indicators, when combined, showed potential value for predicting the risk of cesarean delivery in this population.

  Key words: Gestational diabetes mellitus; Cesarean delivery; Platelet-to-lymphocyte ratio; Maximum vertical pocket of amniotic fluid

  提交时间：2026-11-07

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• 序号	提交日期	编号	操作
  1	2026-09-10	10.12201/bmr.202611.00012V1	下载

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