SCH: Prediction of Preterm Birth in Nulliparous Women

早产(PTB)是一个长期存在的重大公共卫生问题，是导致死亡和 新生儿长期残疾，对家庭和家庭造成严重的情感和经济后果 社会。肺结核风险的预测一直是一个极具挑战性的问题，尤其是第一次 母亲(未分娩的妇女)由于没有以前的孕产史。到目前为止，大多数研究都有 通过对个体风险因素的单变量分析，检查个体风险因素，遗传、环境或行为 与肺结核的关联，包括GWAS确定六个基因上的共同变异的适度贡献 地区。改善结核病预测的挑战是由于其多因素的内在复杂性 病因学和缺乏能够整合和解释大型多学科数据的方法。我们的 以前的工作[NSF Eager 1454855,1454814]开发了基于非遗传因素的肺结核预测模型 母性属性。一个重要的问题是，是否可以使用除肺结核病史之外的其他因素 以确定有风险的未产妇。我们计划为肺结核设计纵向风险预测方法， 集成所有可用的数据。我们将解决当前文学中的三个重要差距，因为我们的 三个项目目标：对未分娩妇女及其患肺结核风险的重点研究；结合基因 与其他临床因素一起决定风险；并使用纵向数据和模型进行优化 安排病人探视、检测和治疗。我们将重点关注最近发布的NIH-NICHD数据集 名为nuMoM2B，这是一项关于种族/民族/地理多样性的前瞻性队列研究 人口10,038名未经产的单胎妊娠妇女。 我们的目标如下：(1)纵向早产预测；(2)临床和遗传学相结合 风险预测的特点；(3)评估方法在临床实践中的有效性。 相关性(请参阅说明)。 每年有超过260亿美元用于分娩和护理12%的新生儿 在美国早产。一个关键的挑战是找出谁是早孕风险最高的女性 早产和制定干预措施。同样重要的是，有能力在 将风险降至最低，以避免不必要和代价高昂的干预。我们的项目有推进的潜力 对这一长期的公共卫生问题的了解。

Preterm Birth (PTB) is a major long-lasting public health problem being the leading cause of mortality and long-term disabilities among neonates, with heavy emotional and financial consequences to families and society. Prediction of PTB risk has been an exceedingly challenging problem, in particular for first time mothers (nulliparous women) due to the lack of prior pregnancy history. Most studies to date have examined individual risk factors, genetic, environmental, or behavioral, through univariate analyses of their association with PTB, including GWAS identifying modest contribution of common variants across six gene regions. The challenge of improving PTB prediction is due to the inherent complexity of its multifactorial etiology and the lack of approaches capable of integrating and interpreting large multidisciplinary data. Our previous work [NSF Eager 1454855, 1454814] developed predictive models for PTB based on non-genetic maternal attributes. An important question is to know whether factors other than history of PTB can be used to identify a nullipara patient at risk. We plan on devising longitudinal risk prediction methods for PTB that integrate every piece of available data. We will address three important gaps in current literature as our three project objectives: a focused study of nulliparous women and their risk for PTB; combining genetic factors with other clinical factors to determine risk ; and using longitudinal data and models to optimize scheduling of patient visits, testing and treatment. We will focus on a recently released NIH-NICHD dataset called nuMoM2b, which is a prospective cohort study of a racially/ethnically/geographically diverse population of10 ,038 nulliparous women with singleton gestation . Our aims are as follows: (1) Longitudinal Preterm Birth Prediction ; (2) Combining clinical and genetic features for risk prediction ; (3) Assessing the effectiveness of the methods in clinical practice. RELEVANCE (See instructions) . Over 26 billion dollars are spent annually on the delivery and care of the 12% of infants who are born preterm in the United States. A crucial challenge is to identify women who are at the highest risk for early preterm birth and to develop interventions. Equally important, would be the ability to identify women at the lowest risk to avoid unnecessary and costly interventions. Our project has the potential to advance knowledge about this long-lasting public health problem.