Xiaoqin Chen,1 Lifang Lin,2 Qiuping Zhong,1 Heming Wu,2 Zhiyuan Zheng,2 Baisen Zhang,3 Liubing Lan1 

1Department of Maternity, Meizhou People’s Hospital, Meizhou City, Guangdong Province, 514031, People’s Republic of China; 2Department of Central Laboratory, Meizhou People’s hospital, Meizhou City, Guangdong Province, 514031, People’s Republic of China; 3Department of Ultrasound, Meizhou People’s hospital, Meizhou City, Guangdong Province, 514031, People’s Republic of China

Correspondence: Liubing Lan, Department of maternity, Meizhou People’s hospital, No. 63, Huang Tang Road, Meijiang District, Meizhou City, Guangdong Province, 514031, People’s Republic of China, Email hipiing1284@sina.com

Objective: To explore the influencing factors of fetal birth defects (BD) and construct a nomogram model.
Methods: A total of 341 newborns admitted to Meizhou people’s hospital from September 2021 to September 2023 were randomly grouped into a modeling group (239 cases) and a validation group (102 cases). The modeling group fetuses were separated into BD and non-BD groups. Multivariate logistic regression analyzed risk factors for BD; R software constructed a nomogram model; Receiver operating characteristic (ROC) curve evaluated the model’s discrimination for BD.
Results: The top 5 types of BD were congenital heart disease, polydactyly/syndactyly, cleft lip/palate, ear malformation, and foot malformation, with incidence rates of 23.81%, 20.63%, 12.70%, 11.11%, and 7.94%, respectively. BD incidence was 26.36% (63/239). Significant differences between BD and non-BD groups were found in maternal age, gestational age, history of adverse pregnancy/childbirth, gestational hypertension, adverse emotions during pregnancy, and folic acid intake duration (P< 0.05). Logistic regression showed maternal age (OR: 4.125), gestational age (OR: 3.066), adverse pregnancy history (OR: 10.628), gestational hypertension (OR: 5.658), adverse emotions (OR: 5.467), and folic acid intake duration (OR: 4.586) were risk factors for BD (P< 0.05). The modeling group’s ROC AUC was 0.938, calibration curve slope close to 1, H-L test =8.342, P=0.692; external validation AUC was 0.961, calibration slope close to 1, H-L test =7.634, P=0.635.
Conclusion: Identified risk factors include maternal age, gestational age, adverse pregnancy history, gestational hypertension, adverse emotions, and folic acid intake duration. The nomogram model shows good discrimination and consistency for evaluating neonatal BD risk.

Keywords: fetus, birth defects, influencing factors, nomogram