硬膜外镇痛对产时发热的影响及发热风险预测模型构建

doi:10.20047/j.issn1673-7210.2023.31.06

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Abstract Objective To research the influence of epidural analgesia on pregnancy outcomes, and to established a risk prediction model of intrapartum fever. Methods A total of 130 pregnant women who voluntarily underwent epidural analgesia delivery in Huaian Maternal and Child Health Hospital, Jiangsu Province (hereinafter referred to as “our hospital”) from April 2018 to April 2022 were selected as the modeling group. They were divided into intrapartum fever group and non-intrapartum fever group according to whether there was intrapartum fever. In addition, 60 pregnant women who underwent epidural analgesia delivery during the same period in our hospital were selected as the validation group. The influencing factors of intrapartum fever were analyzed, and a risk prediction model for predicting intrapartum fever was established, receiver operating characteristic (ROC) curve was used to evaluate the value of the prediction model, and calibration curve and decision curve were established. Results Among 130 pregnant women of epidural analgesia delivery, 44 cases had intrapartum fever. The proportion of oxytocin use, amniotic fluid contamination, and continuous epidural administration in the intrapartum fever group was higher than that in the non-intrapartum fever group, the number of vaginal examination was higher than that the non-intrapartum fever group, and the time from rupture of fetal membrane to the end of delivery was longer than that in the non-intrapartum fever group (P＜0.05). The use of oxytocin, the number of vaginal examination, the time from rupture of fetal membranes to the end of delivery, and the method of epidural administration were the influencing factors of intrapartum fever (OR=4.297, 4.660, 3.939, 3.307, P＜0.05). Risk prediction model Yprediction= 1.458×the use of oxytocin +1.539× the number of vaginal examination+1.371×the time from rupture of fetal membranes to the end of delivery+1.196×the method of epidural administration. ROC curve showed that the maximum Youden index was 0.501 and the area under the curve was 0.793. The calibration curve showed that the predicted probability was in good agreement with the actual probability. The decision curve showed that the prediction model had good clinical applicability. Conclusion The use of oxytocin, the number of vaginal examinations, the time from rupture of fetal membrane to the end of delivery, and the method of epidural administration are all factors that affect intrapartum fever during epidural analgesia, and the risk prediction model based on this has high prediction efficiency and good clinical applicability, which is conducive to the early diagnosis and treatment of intrapartum fever.

Key words： Epidural analgesia Pregnancy outcome Intrapartum fever Risk prediction model

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	LIU Huiling QI Tingting▲

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LIU Huiling QI Tingting▲. Influence of epidural analgesia on intrapartum fever and the construction of fever risk prediction model[J]. 中国医药导报, 2023, 20(31): 34-38.

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https://www.yiyaodaobao.com.cn/EN/10.20047/j.issn1673-7210.2023.31.06 OR https://www.yiyaodaobao.com.cn/EN/Y2023/V20/I31/34

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