Development and validation of a predictive risk model for placental abruption in women with pre-eclampsia using SMOTE

Fangfang Wei, Rong Yang, Zhijuan Rong

Abstract

Placental abruption is a serious complication in pregnant women with preeclampsia. This study investigated the risk factors for placental abruption and developed a predictive model using the Synthetic Minority Over-sampling Technique (SMOTE). A total of 280 pregnant women with preeclampsia treated between September 2020 and September 2025 were enrolled and classified into placental abruption and non-placental abruption groups. Logistic regression showed that parity ≥3, severe preeclampsia, anemia, polyhydramnios, and short umbilical cord were independent risk factors for placental abruption. ROC analysis demonstrated that the SMOTE-based model had better predictive performance than the original model, with a higher AUC (0.863, 95% CI: 0.817–0.901 vs 0.792, 95% CI: 0.739–0.838; z=2.163, P=0.031). The SMOTE-based model also showed higher F-score and positive predictive value, although its true positive rate was lower than that of the original model. These findings indicate that a SMOTE-based predictive model may provide useful support for early risk assessment and prevention of placental abruption in women with preeclampsia.

Full Text:

PDF

References

Akay E, Uzun Gül AD and Türkoğlu A. Recurrent preeclampsia in a pregnant woman with Klippel-Trenaunay syndrome: two cesarean deliveries and multiple extremity involvement - a case report and literature review. BMC Pregnancy Childbirth. 2025 Apr 8;25(1):407. doi: 10.1186/s12884-025-07540-0.

Lin Xueyan, Yang Zi, Shi Junmei and Li Fengqiu. Effect of different referral timing on pregnancy outcomes of women with severe preeclampsia in a referral system [J]. Chinese Journal of Obstetrics and Gynecology, 2022, 57(3): 164-171. doi:10.3760/cma.j.cn112141-20211211-00729

Izumiyama T,Tsuji A,Tanaka K,Tateoka Y,Asahi, R,Hamano H,Hitosugi M and Sugimoto S. Prediction of Placental Abruption of Pregnant Women Drivers with Various Collision Velocities, Seatbelt Positions and Placental Positions—Analysis with Novel Pregnant Occupant Model. Int. J. Environ. Res. Public Health 2024, 21, 827. doi:https://doi.org/10.3390/ijerph21070827.

Guleroglu FY, Ekmez M, Atas BS and Cetin A. Value of hematological indices NLR, PLR, and MPV to determine the clinical outcome of placental abruption in women regarding stillbirth. North Clin Istanb. 2023 Feb 8;10(1):40-47. doi: 10.14744/nci.2022.94752.

Tanaka K, Motozawa Y, Takahashi K, Maki T and Hitosugi M. Factors Affecting the Severity of Placental Abruption in Pregnant Vehicle Drivers: Analysis with a Novel Finite Element Model. Healthcare (Basel). 2021 Dec 24;10(1):27. doi: 10.3390/healthcare10010027.

Binder J, Palmrich P, Kalafat E, Haberl C, Schirwani N, Pateisky P and Khalil A. Longitudinal assessment of angiogenic markers in prediction of adverse outcome in women with confirmed pre-eclampsia. Ultrasound Obstet Gynecol. 2023 Dec;62(6):843-851. doi: 10.1002/uog.26276.

Liu S, Zhou L, Song B, Liu D, Zheng C, Wu X, Wei Z and Chen X. Uterine torsion complicated by severe placental abruption in the second trimester: a case report and literature review. BMC Pregnancy Childbirth. 2023 Jan 21;23(1):51. doi: 10.1186/s12884-023-05377-z.

Mavedatnia D, Tran J, Oltean I, Bijelić V, Moretti F, Lawrence S and El Demellawy D. Impact of Co-Existing Placental Pathologies in Pregnancies Complicated by Placental Abruption and Acute Neonatal Outcomes. J Clin Med. 2021 Dec 3;10(23):5693. doi: 10.3390/jcm10235693.

Sun Min, Wang Ya, Ding Zuoling, Qian Weiqun and Meng Ya. Construction of a fall risk prediction model for elderly patients with sarcopenia based on the SMOTE algorithm [J]. Journal of Nursing Administration, 2024, 24(10): 899-903. doi:10.3969/j.issn.1671-315x.2024.10.014.

Yang Zi and Zhang Weiyuan. Interpretation of the guidelines for diagnosis and treatment of hypertensive disorders in pregnancy (2015) [J]. Chinese Journal of Practical Gynecology and Obstetrics, 2015, 31(10): 886-893. doi:10.7504/fk2015090102.

Obstetrics Group of the Obstetrics and Gynecology Branch of the Chinese Medical Association. Clinical diagnosis and management standards for placental abruption (1st edition) [J]. Chinese Journal of Obstetrics and Gynecology, 2012, 47(12): 957-958. doi:10.3760/cma.j.issn.0529-567x.2012.12.022.

Blagus R and Lusa L. Improved shrunken centroid classifiers for high-dimensional class-imbalanced data. BMC Bioinformatics. 2013 Feb 23;14:64. doi: 10.1186/1471-2105-14-64.

Shi Junmei, Li Fengqiu, Yang Zi, Liang Huili, Han Yiwei, Zhang Huidan and Wang Shuo. Preliminary study on the clinical early warning value of ischemia-modified albumin in the progression of severe preeclampsia [J]. Chinese Journal of Obstetrics and Gynecology, 2024, 59(8): 583-590. doi:10.3760/cma.j.cn112141-20240415-00218.

Wang Jing, Wang Peiping, Zhang Jie and Lixin Shang. Correlation of Siglec-6 and Glycodelin-A levels in serum and placenta with the occurrence of preeclampsia and pregnancy outcomes [J]. Chinese Journal of Reproductive Health, 2023, 34(6): 567-570. doi:10.3760/cma.j.cn112141-20240415-00218.

Li Hui, Jiao Shun, Tan Haibo, Wang Ling and Liu Rong. Expression of serum microRNA-26b in patients with early-onset preeclampsia and its relationship with placental abruption [J]. Chinese Journal of Human Sexuality, 2024, 33(2): 114-117. doi:10.3969/j.issn.1672-1993.2024.02.028.

Wang Qian, Qu Mingli, Wang Yun, Zhang Xujing and Ma Jia. Relationship between thromboelastography α angle, MA value, CI value and the severity of placental abruption and its diagnostic value [J]. Journal of Clinical and Experimental Medicine, 2025, 24(9): 982-986. doi:10.3969/j.issn.1671-4695.2025.09.022.

Zhang Yi and Wang Guohua. Predictive value of combined detection of serum CA125, AFP, and calcium levels for placental abruption in women with preeclampsia [J]. Chinese Journal of Clinical Obstetrics and Gynecology, 2025, 26(1): 77-78. doi:10.13390/j.issn.1672-1861.2025.01.025.

Wang Runfang, Duan Ya, Du Liyan, Liu Xiaodan, Lian Wenning, Huo Yan and Yang Dandan. Epidemiological status and risk factors of placental abruption in pregnant women in Hebei region [J]. Journal of Practical Medicine, 2025, 41(6): 904-910. doi:10.3969/j.issn.1006-5725.2025.06.020.

Chen Lincui, Liu Jing and Tian Rong. Analysis of risk factors and construction of a nomogram prediction model for placental abruption in patients with preeclampsia [J]. Progress in Modern Obstetrics and Gynecology, 2024, 33(10): 757-760, 763. doi:10.13283/j.cnki.xdfckjz.2024.10.005.

Tang Ping, Xiao Jianping, Guo Yunxia and Wang Qimei. Analysis of clinical risk factors for placental abruption in patients with preeclampsia [J]. Chinese Journal of Clinical Obstetrics and Gynecology, 2025, 26(5): 460-461. doi:10.13390/j.issn.1672-1861.2025.05.023

Yang Jing, Yang Jie and Jiang Lili. Construction of an early warning model for postoperative intra-abdominal infection in colorectal cancer patients based on the SMOTE algorithm [J]. Anti-Tumor Pharmacy, 2025, 15(3): 363-369. doi:10.3969/j.issn.2095-1264.2025.03.10.

Qiao Yu, Zhang Yanbo, Yu Hongmei, Cao Hongyan, Zhou Jie, Wang Junxia, Zhang Gaoyuan, Yu Kai, Wang Xueman, Guo Yujiao, Zhao Zhiqiang and Luo Yanhong. Prediction of relapse risk in diffuse large B-cell lymphoma based on SMOTE-ENN and deep forest [J]. Chinese Journal of Health Statistics, 2025, 42(1): 67-72. doi:10.11783/j.issn.1002-3674.2025.01.012.

Refbacks

  • There are currently no refbacks.