胎盘植入性疾病的相关影响因素分析及预测

目的 研究胎盘植入性疾病（placenta accreta spectrum,PAS）的相关影响因素。方法 选取2013年1月1日至2022年10月31日于杭州市西溪医院分娩的154例PAS的孕妇作为观察组，选取同期154例非PAS的孕妇作为对照组。通过单因素及多因素Logistic回归模型分析PAS的相关影响因素。绘制受试者操作特征曲线（receiver operating characteristic curve,ROC曲线）了解模型的区分度。结果 多因素Logistic回归分析结果显示孕妇的年龄、孕次、人工流产史、孕早期保胎史、剖宫产手术史、辅助生殖、前置胎盘是影响PAS的独立危险因素（P<0.05）。胎盘植入发生的联合预测模型的ROC曲线下面积为0.726(95%CI:0.670～0.783)。结论 独立危险因素联合预测PAS的发生具有一定的临床指导意义。加强孕前、孕期检查，及早发现和筛查有高危因素的孕妇并尽早干预，对于减少PAS的发生及母婴并发症具有重要意义。

Analysis and prediction of related influencing factors of placental implantation disease

Objective To study the related influencing factors of placenta accreta spectrum (PAS). Methods A total of 154 pregnant women with PAS who gave birth at Hangzhou Xixi Hospital from January 1, 2013 to October 31, 2022 were selected as the observation group, and 154 pregnant women without PAS during the same period were selected as the control group. The single factor and multiple factor Logistic regression models were used to analyze the related influencing factors of PAS. Receiver operating characteristic (ROC) curve was drawn to understand the differentiation of models. Results Multiple Logistic regression analysis results that the age of pregnant women, gestational number, abortion, protect the fetus in early pregnancy, caesarean section operation, assisted reproduction and placenta previa were independent risk factors for PAS (P<0.05). The area under ROC curve of the joint prediction model for placenta accretion was 0.726(95％CI: 0.670-0.783). Conclusion The combination of independent risk factors in predicting the occurrence of placental implantation has certain clinical guiding significance. Through strengthening pre-pregnancy and pregnancy examination, early detection and screening of high-risk pregnant women, as well as early intervention, is great significance for reducing the occurrence of PAS and maternal and infant complications.