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目的评价Herrera产前生物社会心理模型预测早产的效果及其在上海地区的适用性。方法利用Her-rera模型对前来医院接受产前检查的孕13周及以上的孕妇进行调查和随访,分别在13~27孕周、28~32孕周和33孕周至分娩3个时期对其妊娠情况进行评分和危险分组。记录研究对象的围产期结局。结果Herrera模型判定的高危妊娠者发生早产的危险性增大(OR=10.4,95%CI3.1-34.8),模型的阳性预测值和阴性预测值分别为18.8%和97.8%。ROC曲线分析发现,33孕周至分娩时期模型评分预测效果优于其他两个时期,ROC曲线下面积为0.807(95%CI0.703-0.910)。仅有2名孕产妇存在焦虑,故未能对模型社会心理部分的预测效果进行评价。结论Herrera模型可以有效预测早产的发生,但该模型的社会心理因素指标不太适宜上海孕产妇妊娠期危险因素评价,还需要根据上海的社会经济情况进行修正。
Objective To evaluate the effect of Herrera prenatal bio-psycho-social model in predicting preterm delivery and its applicability in Shanghai. Methods The Her-rera model was used to investigate and follow-up pregnant women who came to the hospital for prenatal examinations of 13 weeks and older. The pregnant women were enrolled in this study from 13 to 27 gestational weeks, from 28 to 32 gestational weeks, and from 33 gestational weeks to 3 stages of delivery Pregnancy scores and hazard groups. Record the study’s perinatal outcome. Results The risk of premature delivery in high-risk pregnancy determined by Herrera model was increased (OR = 10.4,95% CI 3.1-34.8). The positive predictive value and negative predictive value of the model were 18.8% and 97.8% respectively. ROC curve analysis showed that the predictive value of model score from 33 gestational weeks to childbirth was better than the other two periods. The area under the ROC curve was 0.807 (95% CI0.703-0.910). Only 2 pregnant women were anxious, so they failed to evaluate the predictive effect of the social psychology of the model. Conclusion The Herrera model can effectively predict the occurrence of prematurity. However, the psychosocial factors of the model are not suitable for the assessment of risk factors during pregnancy in Shanghai, and need to be revised according to the social and economic conditions in Shanghai.