Objective To construct a nomogram prediction model for the occurrence of fetal distress among pregnant women with high⁃risk pregnancy based on color Doppler flow imaging (CDFI) parameters. Methods The clinical data of 916 pregnant women with high⁃risk pregnancy were retrospectively analyzed. All pregnant women underwent prenatal CDFI examinations of the fetal umbilical artery (UA) and middle cerebral artery (MCA), and CDFI parameters with respect to resistance index (RI), peak systolic/end⁃diastolic ratio (S/D), and pulsatility index (PI) were recorded. According to the presence of fetal distress occurrence, the pregnant women with high⁃risk pregnancy were divided into occurrence group (136 cases) or non⁃occurrence group (780 cases). The Logistic regression model was adopted to analyze factors influencing the occurrence of fetal distress among pregnant women with high⁃risk pregnancy, and a nomogram prediction model was constructed for validation and efficiency evaluation. Results The occurrence group exhibited higher fetal UA RI, PI and S/D, proportion of maternal age ≥35 years, proportion of prolonged labor, and proportion of 1⁃minute post⁃fetus born Apgar score ≤7 compared to the non⁃occurrence group, while lower fetal MCA RI, PI, and S/D as compared with the non⁃occurrence group (P<0.05). The results of Logistic regression analysis revealed that fetal UA PI and S/D, fetal MCA PI and S/D were the influencing factors for the occurrence of fetal distress among pregnant women with high⁃risk pregnancy (P<0.05). The nomogram prediction model constructed based on these influencing factors as above had a C⁃index of 0.853, and the Hosmer⁃Lemeshow test indicated no statistically significant difference between predicted and actual probabilities of the model (P>0.05). The results of receiver operating characteristic curve analysis implied that the model for predicting the occurrence of fetal distress among pregnant women with high⁃risk pregnancy had a sensitivity of 84.40%, specificity of 80.30%, and an area under the curve of 0.867. Conclusion Fetal UA PI and S/D, fetal MCA PI and S/D are the influencing factors for the occurrence of fetal distress among pregnant women with high⁃risk pregnancy. The nomogram model for predicting the occurrence of fetal distress among pregnant women with high⁃risk pregnancy constructed based on these influencing factors demonstrates favorable efficiency.  

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