在密集表型的EHR队列中,先孕期临床风险因素在自发和指示早产之间存在差异
Jean M Costello1,2, Hannah Takasuka3, Jacquelyn Roger4
1Bakar Computational Health Sciences Institute, UCSF, San Francisco, USA.
BMC pregnancy and childbirth
|February 12, 2025
概括
孕产妇诊断强烈预测预示早产 (PTB),但不是自发的PTB. 结合PTB类型会掩盖重要的风险因素,强调需要单独研究自发PTB,以获得新的见解.
科学领域:
- 生殖健康 生殖健康
- 围产儿医学 围产儿医学
- 公共卫生 公共卫生
背景情况:
- 过早分娩 (PTB) 是导致婴儿死亡的主要原因,原因复杂,往往未知.
- 现有的研究受限于数据缺口和难以将PTB分类为指示或自发的困难.
- 电子健康记录 (EHR) 和精选的妊娠数据为PTB研究提供了新的途径.
研究的目的:
- 调查母亲的孕前诊断和早产之间的关联.
- 为了区分指示与自发早产的风险因素.
- 为了利用EHR数据对PTB病理生理学的新见解.
主要方法:
- 在UCSF EHR队列 (10,643名出生) 中,母诊断 (ICD 9/10代码) 和PTB之间的量化关联.
- 对母亲的年龄和社会经济因素进行控制.
- 分别分析指示性和自发性PTB.
主要成果:
- 有30个诊断与PTB相关 (FDR<0.05),包括高血压,糖尿病和脏疾病.
- 基本高血压显示出与指示PTB (aOR = 6) 最强的关联.
- 没有任何与自发性PTB相关的母亲诊断.
结论:
- 在分析中将指示和自发的PTB结合起来,掩盖了由指示出生驱动的重大关联.
- 单独调查自发性PTB对于了解其独特的途径至关重要.
- 这种方法可以识别有风险的个体,并推进PTB知识.
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