产后1年新发或加重压力性尿失禁的预测：临床列线图的开发和外部验证
Prediction of new-onset or worsened stress urinary incontinence 1 year postpartum: Development and external validation of a clinical nomogram.
摘要(中文译文)
本研究开发并外部验证了一个用于预测产后1年新发或加重压力性尿失禁（SUI）的列线图。本前瞻性队列研究纳入来自中国北京两家三级医院的女性。训练队列（n=2190）用于开发模型，外部验证队列（n=1040）用于评估其性能。新发或加重SUI定义为产后42天至1年间出现新发症状或症状严重程度增加。多变量logistic回归识别预测因子并构建列线图。采用区分度、校准度和决策曲线分析（DCA）评估模型性能。产后1年时，训练队列中15.9%（349/2190）的女性及验证队列中21.1%（219/1040）的女性出现新发或加重SUI。独立预测因子包括自然阴道分娩（比值比[OR] 1.914，95%置信区间[CI] 1.414-2.592）、产钳助产（OR 2.179，95% CI 1.400-3.391）、多产次（OR 1.669，95% CI 1.274-2.187）、肥胖（OR 3.132，95% CI 1.231-7.969）及妊娠期糖尿病（OR 1.309，95% CI 1.010-1.696）。盆底康复与风险降低相关（OR 0.348-0.403，均P<0.001）。列线图显示出可接受的区分度，训练队列和验证队列的C指数分别为0.717（95% CI 0.686-0.748）和0.792（95% CI 0.755-0.828）。校准度和DCA表明良好的一致性和潜在的临床实用性。该列线图为识别产后1年新发或加重SUI风险升高的女性提供了可靠的预测准确性和临床实用性，为早期风险分层和个体化预防提供了实用工具。
Abstract
This study develops and externally validates a nomogram for predicting new-onset or worsened stress urinary incontinence (SUI) at 1 year postpartum. This prospective cohort study included women from two tertiary hospitals in Beijing, China. A training cohort (n = 2190) was used to develop the model and an external validation cohort (n = 1040) to assess its performance. New-onset or worsened SUI was defined as de novo symptoms or increased symptom severity between 42 days and 1 year postpartum. Multivariable logistic regression identified predictors and constructed the nomogram. Model performance was evaluated using discrimination, calibration, and decision curve analysis (DCA). At 1 year postpartum, 15.9% (349/2190) of women in the training cohort and 21.1% (219/1040) in the validation cohort developed new-onset or worsened SUI. Independent predictors included spontaneous vaginal delivery (odds ratio [OR] 1.914, 95% confidence interval [CI] 1.414-2.592), forceps delivery (OR 2.179, 95% CI 1.400-3.391), multiparity (OR 1.669, 95% CI 1.274-2.187), obesity (OR 3.132, 95% CI 1.231-7.969), and gestational diabetes mellitus (OR 1.309, 95% CI 1.010-1.696). Pelvic floor rehabilitation was associated with reduced risk (OR 0.348-0.403, both P < 0.001). The nomogram showed acceptable discrimination, with C-indices of 0.717 (95% CI 0.686-0.748) and 0.792 (95% CI 0.755-0.828) in the training and validation cohorts, respectively. Calibration and DCA indicated good agreement and potential clinical utility. This nomogram provides reliable predictive accuracy and clinical utility for identifying women at elevated risk of new-onset or worsened SUI at 1 year postpartum, offering a practical tool for early risk stratification and individualized prevention.
如何引用
AMA
Xiaoxiao Wang, Lei Zhang, Xiaoqing Wang, Songwen Nian, Lan Zhu, Ye Lu. Prediction of new-onset or worsened stress urinary incontinence 1 year postpartum: Development and external validation of a clinical nomogram.. International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics. 2026; doi:10.1002/ijgo.71202.
APA
Xiaoxiao Wang, Lei Zhang, Xiaoqing Wang, Songwen Nian, Lan Zhu, Ye Lu (2026). Prediction of new-onset or worsened stress urinary incontinence 1 year postpartum: Development and external validation of a clinical nomogram.. International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics. https://doi.org/10.1002/ijgo.71202
GB/T 7714
Xiaoxiao Wang, Lei Zhang, Xiaoqing Wang, Songwen Nian, Lan Zhu, Ye Lu. Prediction of new-onset or worsened stress urinary incontinence 1 year postpartum: Development and external validation of a clinical nomogram.[J]. International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics, 2026 doi:10.1002/ijgo.71202.
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