Analysis of risk factors and construction of nomograph model for critical condition of patients with hypertension during pregnancy.

OBJECTIVE

This study aims to construct the risk prediction nomogram model of critical condition in patients with hypertension during pregnancy and to verify its evaluation effect.

METHODS

A total of 531 patients with hypertension during pregnancy were randomly grouped into 427 model group and 104 validation group. The model group patients included 59 cases of critical group and 368 cases of non-critical group according to the occurrence of critical situation. Multivariate Logistic regression analysis was conducted to determine the risk factors of critical condition in patients with hypertension during pregnancy, and R software was used to construct the nomogram model. Moreover, the prediction efficiency of the model was evaluated.

RESULTS

The proportions of patients aged over 30 years, with an educational background of junior high school or below, a family history of hypertension, anemia during pregnancy, and a lower erythrocyte count were significantly higher in the critical group compared to the non-critical group (P < 0.05). Age > 30 years old, educational background of junior high school and below, family history of hypertension, anemia during pregnancy, and red blood cell count were independent risk factors for the occurrence of critical condition in patients with hypertension during pregnancy (P < 0.05). The prediction model formula Z = 1.857×Age + 1.167×Education + 1.601×Family history of hypertension + 1.815×Pregnancy anemia + 3.524×Red blood cell count+(-19.769). The area under the curve (AUC) of the nomogram in the modeling group for predicting the risk of critical situations was 0.926 (95% CI = 0.887 ~ 0.964), indicating excellent discrimination. The calibration curve closely resembled the ideal curve, demonstrating good agreement between the predicted and actual values. The AUC of the validation group's nomogram to predict the risk of critical situation was 0.942 (95% CI = 0.872 ~ 0.998), with good discrimination. The calibration curve was close to the ideal curve, and the actual value was in good agreement with the predicted value.

CONCLUSION

The nomograph model can predict the risk of critical condition in patients with hypertension during pregnancy and screen high-risk population.