考虑到种族和社会经济地位的产前查 - 竞争风险模型和风险因子评分的比较
Anastasija Arechvo1, Argyro Syngelaki1, Ranjit Akolekar2
1Fetal Medicine Research Institute, King's College Hospital, London, United Kingdom; Institute of Women and Children's Health, School of Life Course and Population Sciences, King's College London, United Kingdom (UK).
概括
胎儿医学基金会 (FMF) 的模型显示了与风险因子查相似的前 (PE) 检测,但查阳性率较低 (SPR). 这种改善的查在怀孕早期发生,有助于及时服用阿司匹林来预防早产儿.
科学领域:
- 孕产妇和胎儿的医学
- 产科和妇科
- 流行病学
背景情况:
- 对于及时干预而言,孕前 (PE) 查至关重要.
- 目前的查方法包括临床风险因素和多变量模型.
- 优化查策略可以改善母亲和胎儿的结果.
研究的目的:
- 将胎儿医学基金会 (FMF) 多变量竞争风险模型与传统临床风险因子进行预先查的性能进行比较.
- 评估FMF模型和国家卫生和护理卓越研究所 (NICE) 修改的方法在检测早产和晚产前期的有效性.
主要方法:
- 预期对象研究单子妊娠产后≥24周.
- FMF模型与NICE指导和包括黑人种族和社会贫困在内的"NICE修改"方法的比较 (多重贫困指数 (IMD) 1-4).
- 查策略与查阳性率 (SPR) 相匹配,以便直接比较检测率 (DR).
主要成果:
- 在11至13周,FMF模型 (SPR 7. 4%) 实现了与NICE修改的查 (SPR 40. 1%,DR 67. 4%) 类似的早产儿发育率 (DR 67.
- 在35-36周,FMF模型 (SPR 10. 9%) 显示了较高的后续PE的DR (70. 5%),而不是NICE修改的查 (SPR 37. 4%,DR 61. 5%).
- FMF模型显示了更好的检测,特别是在黑人女性和不同社会经济地位中.
结论:
- 该模型提供了与传统基于危险因素的查可比的孕前风险检测.
- FMF模型实现了这一目标,查阳性率显著降低,特别是在使用阿司匹林预防早产儿期的11-13周.
- 这种在怀孕早期和晚期加强的查有助于及时干预早产和早产前.
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