Combining adverse pregnancy and perinatal outcomes for women exposed to antiepileptic drugs during pregnancy, using a latent trait model.
Combining adverse pregnancy and perinatal outcomes for women exposed to antiepileptic drugs during pregnancy, using a latent trait model.
复制标题
DOI：
10.1186/s12884-016-1190-7
复制
发表时间：
2017-01-06
影响因子：
3.1
通讯作者：
Meador KJ
中科院分区：
文献类型：
--
作者：
Wen X;Hartzema A;Delaney JA;Brumback B;Liu X;Egerman R;Roth J;Segal R;Meador KJ
潜变量模型在医学研究中的应用越来越广泛。一个潜在的特质模型，结合联合收割机罕见的出生缺陷的结果，婴儿发病率的指数。这项研究采用了四个全州范围的回顾性10年数据源（1999年至2009年）。研究队列由所有在研究期间分娩活产单胎婴儿的佛罗里达医疗补助计划女性登记者组成。药物暴露定义为妊娠期间任何抗癫痫药物（AED）暴露。未接触AED的母亲作为AED未接触组进行比较。四个不良结局，出生缺陷（BD），新生儿异常状况（ACNB），低出生体重（LBW），妊娠和产科并发症（PCOC），进行了检查，并结合使用一个潜在的特质模型，以产生一个整体的严重程度指数。单一性，局部独立性，内部同质性和结构效度进行了评价的组合结果。研究队列包括总AED组的3183对母婴，仅丙戊酸盐亚组的226对母婴和AED未暴露组的43，956对母婴。与AED未暴露组相比，总AED组（12.8% vs. 10.5%，P <.0001）和仅丙戊酸盐亚组（19.6% vs. 10.5%，P <.0001）的BD发生率均较高。在全AED组（Rho = 0.24，P <0.0001）和仅丙戊酸盐亚组（Rho = 0.16，P = 0.01）中，综合结局与分娩期间住院时间显著相关。总AED组的综合结局平均评分显著高于AED未暴露组（2.04 ± 0.02 vs. 1.88 ± 0.01，P <0.0001），而丙戊酸盐单药亚组则无此差异。潜在性状模型可以是一种有效的工具，结合不良妊娠和围产期结局，以评估产前暴露于AED，但所选组件的评价是必不可少的，以确保联合结果的有效性。本文的在线版本（doi：10.1186/s12884 - 016 - 1190 - 7）包含补充材料，可供授权用户使用。
Application of latent variable models in medical research are becoming increasingly popular. A latent trait model is developed to combine rare birth defect outcomes in an index of infant morbidity. This study employed four statewide, retrospective 10-year data sources (1999 to 2009). The study cohort consisted of all female Florida Medicaid enrollees who delivered a live singleton infant during study period. Drug exposure was defined as any exposure to Antiepileptic drugs (AEDs) during pregnancy. Mothers with no AED exposure served as the AED unexposed group for comparison. Four adverse outcomes, birth defect (BD), abnormal condition of new born (ACNB), low birth weight (LBW), and pregnancy and obstetrical complication (PCOC), were examined and combined using a latent trait model to generate an overall severity index. Unidimentionality, local independence, internal homogeneity, and construct validity were evaluated for the combined outcome. The study cohort consisted of 3183 mother-infant pairs in total AED group, 226 in the valproate only subgroup, and 43,956 in the AED unexposed group. Compared to AED unexposed group, the rate of BD was higher in both the total AED group (12.8% vs. 10.5%, P < .0001), and the valproate only subgroup (19.6% vs. 10.5%, P < .0001). The combined outcome was significantly correlated with the length of hospital stay during delivery in both the total AED group (Rho = 0.24, P < .0001) and the valproate only subgroup (Rho = 0.16, P = .01). The mean score for the combined outcome in the total AED group was significantly higher (2.04 ± 0.02 vs. 1.88 ± 0.01, P < .0001) than AED unexposed group, whereas the valproate only subgroup was not. Latent trait modeling can be an effective tool for combining adverse pregnancy and perinatal outcomes to assess prenatal exposure to AED, but evaluation of the selected components is essential to ensure the validity of the combined outcome. The online version of this article (doi:10.1186/s12884-016-1190-7) contains supplementary material, which is available to authorized users.
登录
查看更多内容
DOI：
10.1136/bmj.c3920
发表时间：
2010-08-18
期刊：
BMJ (Clinical research ed.)
影响因子：
--
作者：
Cordoba G;Schwartz L;Woloshin S;Bae H;Gøtzsche PC
通讯作者：
Gøtzsche PC
影响因子：
2.2
作者：
Kaneko, S;Battino, D;Teranishi, T
通讯作者：
Teranishi, T
影响因子：
2.7
作者：
Kimberlin, Carole L.;Winterstein, Almut G.
通讯作者：
Winterstein, Almut G.
影响因子：
2.6
作者：
Andrade, Susan E.;Raebel, Marsha A.;Gurwitz, Jerry H.
通讯作者：
Gurwitz, Jerry H.
影响因子：
11
作者：
Campbell, E.;Kennedy, F.;Morrow, J.
通讯作者：
Morrow, J.