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. 2023 May 18:14:1065291.
doi: 10.3389/fendo.2023.1065291. eCollection 2023.

Nomogram for predicting the risk of preterm delivery after IVF/ICSI treatment: an analysis of 11513 singleton births

Zhiqi Liao  1 , Lei Cai  1 , Chang Liu  2 , Jie Li  1 , Xinyao Hu  1 , Youhua Lai  3 , Lin Shen  1 , Cong Sui  1 , Hanwang Zhang  1 , Kun Qian  1
Affiliations

Nomogram for predicting the risk of preterm delivery after IVF/ICSI treatment: an analysis of 11513 singleton births

Zhiqi Liao et al. Front Endocrinol (Lausanne). .

Abstract

Background: There is a higher risk of preterm delivery (PTD) in singleton live births conceived after in vitro fertilization (IVF)/intracytoplasmic sperm injection (ICSI) compared with spontaneously conceived pregnancies. The objective of our study was to build a predictive nomogram model to suggest the possibility of PTD in singleton pregnancies after IVF/ICSI treatment.

Method: 11513 IVF/ICSI cycles with singleton live births were enrolled retrospectively. These cycles were randomly allocated into a training group (80%) and a validation group (20%). We used the multivariate logistics regression analysis to determine prognostic factors for PTD in the training group. A nomogram based on the above factors was further established for predicting PTD. Receiver operating characteristic curves (ROC), areas under the ROC curves (AUC), concordance index (C-index), and calibration plots were analyzed for assessing the performance of this nomogram in the training and validation group.

Results: There were fourteen risk factors significantly related to PTD in IVF/ICSI singleton live births, including maternal body mass index (BMI) > 24 kg/m2, smoking, uterine factors, cervical factors, ovulatory factors, double embryo transferred (DET), blastocyst transfer, FET, vanishing twin syndrome (VTS), obstetric complications (placenta previa, placenta abruption, hypertensive of pregnancies, and premature rupture of membrane), and a male fetus. These factors were further incorporated to construct a nomogram prediction model. The AUC, C-index, and calibration curves indicated that this nomogram exhibited fair performance and good calibration.

Conclusions: We found that the occurrence of PTD increased when women with obesity, smoking, uterine factors, cervical factors, ovulatory factors, DET, VTS, and obstetric complications, and a male fetus. Furthermore, a nomogram was constructed based on the above factors and it might have great value for clinic use.

Keywords: in vitro fertilization; intracytoplasmic sperm injection; nomogram; prediction; preterm birth.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Flow chart of data selection.
Figure 2
Figure 2
The nomogram to predict the incidence of PTD in patients after IVF/ICSI. It includes female body mass index (BMI), smoking, uterine factors, cervical factors, ovulatory factors, No. of embryo transferred, blastocyst transfer, frozen-thawed embryo transfer (FET), gestational sacs, placenta previa (PP), placenta abruption (PA), hypertensive of pregnancies (HDP), and premature rupture of membrane (PROM). The usage of this nomogram is interpreted in an assumptive woman with BMI >24 kg/m2, smoking habit, cervical factors, two embryo transfer (DET), FET, two gestational sacs, and a male fetus. For this woman, the total point added up to 4.92, which indicated approximately 0.792 of probability of PTD incidence. *P<0.05, **P<0.01, ***P<0.001.
Figure 3
Figure 3
The calibration plots and receiver operator characteristic curves (ROC) of the nomogram in the training and validation group. Calibration plots in (A) the training group and (C) validation group. ROC in (B) the training group and (D) validation group.
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