Development and validation of a risk prediction index for severe maternal morbidity based on preconception comorbidities among infertile patients.
Development and validation of a risk prediction index for severe maternal morbidity based on preconception comorbidities among infertile patients.
复制标题
DOI：
10.1016/j.fertnstert.2021.06.024
复制
发表时间：
2021-11
影响因子：
6.7
通讯作者：
Leonard SA
中科院分区：
文献类型：
--
作者：
Murugappan G;Alvero RJ;Lyell DJ;Khandelwal A;Leonard SA
在不孕症患者中，开发并验证严重孕产妇发病率（SMM）的孕前风险预测指数，该指数由CDC定义为危及生命的并发症的指标。2007-2017年不孕妇女活产和死胎的回顾性分析。国家商业索赔数据库。根据诊断、检测或治疗代码确定的不孕妇女。无主要结局是SMM，被确定为CDC指数中的任何指标，但输血单独被发现高估了病例。从既往文献中选择了20种与SMM风险相关的孕前合并症。有针对性的集成学习方法被用于将合并症的重要性列为SMM的潜在风险因素。然后使用每种合并症与SMM之间的独立关联强度来定义每种合并症的风险评分。在94，097名分娩的不孕妇女中，2.3%（n= 2，181）发生了SMM事件。肺动脉高压、血液系统疾病、肾脏疾病和心脏疾病是SMM的最高风险。药物滥用障碍、既往剖腹产、年龄> 40岁、胃肠道疾病、贫血、心理健康障碍和哮喘的相关重大风险最低。合并症评分的ROC-AUC为0.66。校准图显示SMM的预测和实际风险之间具有良好的一致性。我们开发并验证了一种基于孕前合并症预测不孕症患者SMM概率的指数。该工具可以为不孕妇女的孕前咨询提供信息，并支持孕产妇健康研究计划。不孕症患者中基于孕前合并症的严重孕产妇发病风险预测指数的开发和验证该工具可为不孕妇女的孕前咨询提供信息。
To develop and validate a pre-conception risk prediction index for severe maternal morbidity (SMM), defined by the CDC as indicators of a life-threatening complication, among infertile patients. Retrospective analysis of livebirths and stillbirths from 2007–2017 among infertile women. National commercial claims database. Infertile women identified based on diagnosis, testing, or treatment codes. None The primary outcome was SMM, identified as any indicator from the CDC Index except blood transfusion alone which has been found to overestimate cases. Twenty preconception comorbidities associated with risk of SMM were selected from prior literature. Targeted ensemble learning methods were used to rank the importance of comorbidities as potential risk factors for SMM. The independent strength of association between each comorbidity and SMM was then used to define each comorbidity’s risk score. Among 94,097 infertile women with a delivery, 2.3% (n=2,181) experienced an SMM event. The highest risk of SMM was conferred by pulmonary hypertension, hematologic disorders, renal disease, and cardiac disease. Associated significant risks were lowest for substance abuse disorders, prior cesarean section, age > 40 years, gastrointestinal disease, anemia, mental health disorders and asthma. The ROC-AUC for the developed comorbidity score was 0.66. Calibration plots showed good concordance between predicted and actual risk of SMM. We developed and validated an index to predict the probability of SMM in patients with infertility based on preconception comorbidities. This tool may inform preconception counseling of infertile women and support maternal health research initiatives. Development and validation of a risk prediction index for severe maternal morbidity based on preconception comorbidities among infertile patients. This tool may inform preconception counseling of infertile women.
登录
查看更多内容
影响因子：
15.8
作者：
Lisonkova S;Potts J;Muraca GM;Razaz N;Sabr Y;Chan WS;Kramer MS
通讯作者：
Kramer MS
影响因子：
7.2
作者：
Grobman, William A.;Bailit, Jennifer L.;Van Dorsten, J. Peter
通讯作者：
Van Dorsten, J. Peter
影响因子：
9.8
作者：
Creanga, Andreea A.;Bateman, Brian T.;Callaghan, William M.
通讯作者：
Callaghan, William M.
影响因子：
7.2
作者：
Martin, Angela S.;Monsour, Michael;Boulet, Sheree L.
通讯作者：
Boulet, Sheree L.
DOI：
10.3109/14767058.2012.710280
发表时间：
2012-12
期刊：
The journal of maternal-fetal & neonatal medicine : the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians
影响因子：
--
作者：
Lyndon A;Lee HC;Gilbert WM;Gould JB;Lee KA
通讯作者：
Lee KA