Risk-factor model for postpartum hemorrhage after cesarean delivery: a retrospective study based on 3498 patients

作者全名："Gong, Jun; Chen, Zhi; Zhang, Yi; Liu, Yi-yun; Pu, Jun-cai; Xiong, Chun-yan; Gui, Si-wen; He, Xiao-ling; Wang, Hui-lai; Zhong, Xiao-gang"

作者地址："[Gong, Jun; Wang, Hui-lai] Chongqing Med Univ, Dept Informat Ctr, Univ Town Hosp, Chongqing 401331, Peoples R China; [Gong, Jun; Wang, Hui-lai; Zhong, Xiao-gang] Chongqing Med Univ, Med Data Sci Acad, Chongqing 400016, Peoples R China; [Chen, Zhi; He, Xiao-ling] Chongqing Med Univ, Dept Obstet & Gynecol, Affiliated Hosp 1, Chongqing 400016, Peoples R China; [Zhang, Yi] Chongqing Med Univ, Sch Publ Hlth & Management, Chongqing 400016, Peoples R China; [Liu, Yi-yun; Pu, Jun-cai; Gui, Si-wen] Chongqing Med Univ, Affiliated Hosp 1, NHC Key Lab Diag & Treatment Brain Funct Dis, Chongqing 400016, Peoples R China; [Xiong, Chun-yan] Chongqing Med Univ, Dept Obstet & Gynecol, Univ Town Hosp, Chongqing 401331, Peoples R China; [Zhong, Xiao-gang] Chongqing Med Univ, Key Lab Psychoseomadsy, Stomatol Hosp, Chongqing 401147, Peoples R China; [Zhong, Xiao-gang] Chongqing Med Univ, Coll Basic Med, Chongqing 400016, Peoples R China"

通信作者："Wang, HL (通讯作者)，Chongqing Med Univ, Dept Informat Ctr, Univ Town Hosp, Chongqing 401331, Peoples R China.; Wang, HL; Zhong, XG (通讯作者)，Chongqing Med Univ, Med Data Sci Acad, Chongqing 400016, Peoples R China.; Zhong, XG (通讯作者)，Chongqing Med Univ, Key Lab Psychoseomadsy, Stomatol Hosp, Chongqing 401147, Peoples R China.; Zhong, XG (通讯作者)，Chongqing Med Univ, Coll Basic Med, Chongqing 400016, Peoples R China."

来源：SCIENTIFIC REPORTS

ESI学科分类：Multidisciplinary

WOS号：WOS:000934072600010

JCR分区：Q1

影响因子：4.6

年份：2022

卷号：12

期号：1

开始页：　

结束页：　

文献类型：Article

关键词：　

摘要："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."

基金机构：Science and Technology Research Project of Chongqing [cstc2015shms-ztzx10011]; Intelligent medicine project of Chongqing Medical University [ZHYX2019005]

基金资助正文："We are very grateful to the participants involved in this study, and we are also very grateful to Dr. Ting Zhang for her guidance in obstetrics and gynecology. This work was supported by the Science and Technology Research Project of Chongqing (Grant numbers: cstc2015shms-ztzx10011) and the Intelligent medicine project of Chongqing Medical University (Grant numbers: ZHYX2019005). In addition, we thank Home for Researchers (www.home-for-researchers.com), for editing the English text of a draft of this manuscript."