{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,8]],"date-time":"2026-11-08T00:44:27Z","timestamp":1794098667601,"version":"4.8.0"},"reference-count":20,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2023,9,7]],"date-time":"2023-09-07T00:00:00Z","timestamp":1694044800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2023,9,7]],"date-time":"2023-09-07T00:00:00Z","timestamp":1694044800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Pregnancy Childbirth"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To explore the risk factors and develop a predictive model for postpartum hemorrhage in twin pregnancies.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      All patients who gave birth at Ningbo Women and Children\u2019s Hospital from January 2018 to August 2022 were recruited. Patients were randomly allocated to a training cohort (n\n                      <jats:inline-formula>\n                        <jats:alternatives>\n                          <jats:tex-math>$$=$$<\/jats:tex-math>\n                          <mml:math xmlns:mml=\"http:\/\/www.w3.org\/1998\/Math\/MathML\">\n                            <mml:mo>=<\/mml:mo>\n                          <\/mml:math>\n                        <\/jats:alternatives>\n                      <\/jats:inline-formula>\n                      1395) validation cohort (n\n                      <jats:inline-formula>\n                        <jats:alternatives>\n                          <jats:tex-math>$$=$$<\/jats:tex-math>\n                          <mml:math xmlns:mml=\"http:\/\/www.w3.org\/1998\/Math\/MathML\">\n                            <mml:mo>=<\/mml:mo>\n                          <\/mml:math>\n                        <\/jats:alternatives>\n                      <\/jats:inline-formula>\n                      650) at a 7:3 ratio. In the training cohort, LASSO regression for screening variables and multifactorial logistic regression analysis were performed to identify independent risk factors for postpartum hemorrhage in twin pregnancies. A nomogram was established based on the results of multiple logistic regression analysis. Nomogram performance was quantified using the receiver operating characteristic curve, Hosmer- Lemeshow test and decision curve analysis.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 2045 patients were included in this study. Multifactorial Logistic regression analysis showed maternal age, assisted reproduction, platelet count, fibrinogen level, albumin level, hypertensive disorders of pregnancy, placenta praevia, number of previous cesarean deliveries, number of previous intrauterine manipulation, and neonatal weight were independent risk factors for postpartum hemorrhage in twin births. The area under curve (AUC) for the training cohort was 0.810 [95\n                      <jats:inline-formula>\n                        <jats:alternatives>\n                          <jats:tex-math>$$\\%$$<\/jats:tex-math>\n                          <mml:math xmlns:mml=\"http:\/\/www.w3.org\/1998\/Math\/MathML\">\n                            <mml:mo>%<\/mml:mo>\n                          <\/mml:math>\n                        <\/jats:alternatives>\n                      <\/jats:inline-formula>\n                      CI (0.781, 0.839)], with a sensitivity of 76.5\n                      <jats:inline-formula>\n                        <jats:alternatives>\n                          <jats:tex-math>$$\\%$$<\/jats:tex-math>\n                          <mml:math xmlns:mml=\"http:\/\/www.w3.org\/1998\/Math\/MathML\">\n                            <mml:mo>%<\/mml:mo>\n                          <\/mml:math>\n                        <\/jats:alternatives>\n                      <\/jats:inline-formula>\n                      , specificity of 71.0\n                      <jats:inline-formula>\n                        <jats:alternatives>\n                          <jats:tex-math>$$\\%$$<\/jats:tex-math>\n                          <mml:math xmlns:mml=\"http:\/\/www.w3.org\/1998\/Math\/MathML\">\n                            <mml:mo>%<\/mml:mo>\n                          <\/mml:math>\n                        <\/jats:alternatives>\n                      <\/jats:inline-formula>\n                      , and positive and negative predictive values of 0.358 and 0.935, respectively, while the AUC for the validation cohort was 0.821 [95\n                      <jats:inline-formula>\n                        <jats:alternatives>\n                          <jats:tex-math>$$\\%$$<\/jats:tex-math>\n                          <mml:math xmlns:mml=\"http:\/\/www.w3.org\/1998\/Math\/MathML\">\n                            <mml:mo>%<\/mml:mo>\n                          <\/mml:math>\n                        <\/jats:alternatives>\n                      <\/jats:inline-formula>\n                      CI (0.781, 0.860)], with a sensitivity of 80.9\n                      <jats:inline-formula>\n                        <jats:alternatives>\n                          <jats:tex-math>$$\\%$$<\/jats:tex-math>\n                          <mml:math xmlns:mml=\"http:\/\/www.w3.org\/1998\/Math\/MathML\">\n                            <mml:mo>%<\/mml:mo>\n                          <\/mml:math>\n                        <\/jats:alternatives>\n                      <\/jats:inline-formula>\n                      , specificity of 69.49\n                      <jats:inline-formula>\n                        <jats:alternatives>\n                          <jats:tex-math>$$\\%$$<\/jats:tex-math>\n                          <mml:math xmlns:mml=\"http:\/\/www.w3.org\/1998\/Math\/MathML\">\n                            <mml:mo>%<\/mml:mo>\n                          <\/mml:math>\n                        <\/jats:alternatives>\n                      <\/jats:inline-formula>\n                      , and positive predictive value and negative predictive value of 0.426 and 0.929, respectively.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The predictive model can effectively and quantitatively assess the risk of postpartum hemorrhage in twin pregnancies and help clinicians to take personalized preventive measures.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s12884-023-05933-7","type":"journal-article","created":{"date-parts":[[2023,9,7]],"date-time":"2023-09-07T11:03:08Z","timestamp":1694084588000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Establishment of a predictive model for postpartum hemorrhage in twins: a retrospective study"],"prefix":"10.1186","volume":"23","author":[{"given":"Sangsang","family":"Qi","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xianhu","family":"Fu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2023,9,7]]},"reference":[{"key":"5933_CR1","doi-asserted-by":"crossref","unstructured":"Jayakumaran JS, Schuster M, Ananth CV. 260: Postpartum hemorrhage and its risk of maternal deaths in the US. 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The Institutional Review Board of Ningbo Women and Children\u2019s waived the need for informed consent because of the retrospective nature of this study. The research was conducted according to the ethical standard of the Helsinki Declaration, and the patient data were stored anonymously in a dedicated database. All methods were carried out in accordance with relevant guidelines and regulations.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"644"}}