Estimation of the risk factors in pregnant women and prediction of congenital fetal anomalies

Abstract

Aim. To estimate the value of different maternal risk factors to develop a prognostic model for prevention of fetal congenital anomalies.
 Methods. A prospective complex clinical and laboratory and functional examination of 629 pregnant women with fetal congenital anomalies and 206 pregnant women without fetal pathology was conducted with a comparative assessment of the medical and social risk factors for congenital defects. To build a predictive model for prevention of congenital anomalies, the logistic regression method was used.
 Results. According to static analysis, significant medical and social risk factors for congenital anomalies are acute respiratory viral infection with fever in early gestational age (OR=20.0, 95 % CI: 2.756-145.7), the absence of prophylactic folic acid (OR=15.16, 95 % CI: 7.35-31.31), polyhydramnion (OR=14.2, 95 % CI: 4.453-45.18), oligohydramnion (OR=3.258, 95 % CI: 1.382-7.679), preeclampsia (OR=3.51, 95 % CI: 1.11-8.96) and maternal anemia (OR=4.75, 95 % CI: 2.51-8.99). As a result, we received the predictive model with high sensitivity equal to 0.924, specificity 0.655 and Sommers’ D 0.629. Nagelkerke’s R square of the model was 0.552 (moderate). This means that the model explains 55.2 % variation of the dependent variable.
 Conclusion. The conducted study allowed identifying the predictors affecting the development of congenital fetal anomalies, and the developed predictive model for determining the probability of congenital fetal anomalies in the early antenatal period is characterized by high sensitivity and can be suggested for the use during the monitoring phase of the pregnant woman in the outpatient setting.