Prediction of fetal loss in Chinese pregnant patients with systemic lupus erythematosus: a retrospective cohort study

BMJ Open
Jiayue WuWen Di

Abstract

To develop a predictive model for fetal loss in women with systemic lupus erythematosus (SLE). A retrospective cohort study. Data were collected in a tertiary medical centre, located in Shanghai, China, from September 2011 to May 2017. 338 pregnancies with SLE were analysed retrospectively. Cases of multiple pregnancy and those in which artificial abortion was performed for personal reasons were excluded. Fetal loss was the primary outcome. A stepwise regression to identify the predictors related to the fetal loss and coefficient B of each variable was used to develop a predictive model and make a corresponding risk classification. The Hosmer-Lemeshow test, Omnibus test and area under the receiver-operating characteristic curve (AUC) were used to assess the goodness-of-fit and discrimination of the predictive model. A 10-fold cross validation was used to assess the model for overfitting. Unplanned pregnancies (OR 2.84, 95% CI 1.12 to 7.22), C3 hypocomplementemia (OR 5.46, 95% CI 2.30 to 12.97) and 24 hour-urinary protein level (0.3≤protein<1.0 g/24 hours: OR 2.10, 95% CI 0.63 to 6.95; protein≥1.0 g/24 hours: OR 5.89, 95% CI 2.30 to 15.06) were selected by the stepwise regression. The Hosmer-Lemeshow test resulted in p=0.325; th...Continue Reading

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