Academic literature on the topic 'Pregnancy outcome predictors'
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Journal articles on the topic "Pregnancy outcome predictors"
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Sinyakova, Anna A., Elena V. Shipitsyna, Olga V. Budilovskaya, Vyacheslav M. Bolotskikh, and Alevtina M. Savicheva. "Anamnestic and microbiological predictors of miscarriage." Journal of obstetrics and women's diseases 68, no. 2 (May 29, 2019): 59–70. http://dx.doi.org/10.17816/jowd68259-70.
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Hypothesis/aims of study. Miscarriage is a significant medical and social problem. The etiology of pregnancy losses is diverse and depends on many factors. It is believed that dysbiotic disorders of the vagina are one of the main causes of this pathology. While the etiopathogenesis of miscarriage is actively studied, many questions still remain open. The aim of the study was to investigate anamnestic and microbiological predictor factors of miscarriage.
Study design, materials, and methods. In a prospective cohort study, 159 pregnant women were examined in the first trimester of pregnancy: the anamnesis, course of pregnancy, vaginal microflora, and present pregnancy outcome were studied. The vaginal microflora was analyzed using microscopic, bacteriological and quantitative real-time PCR methods. Depending on the present pregnancy outcome, the patients were divided into two groups: those delivered at term and women with early and late miscarriage. The analysis of predictors of miscarriage of the ongoing pregnancy was performed depending on the period of delivery.
Results. The rate of miscarriage in women was 13%. The independent predictors of early miscarriage were chronic endometritis (OR 10.54; 95% CI 2.54 to 43.64), the dominance of Lactobacillus iners in the vaginal microflora (OR 8.52; 95% CI 2.07 to 35.05), and the prevalence of non-Lactobacillus species in microscopy of vaginal preparations (OR 4.50; 95% CI 1.02 to 19.69). The dominance of Lactobacillus crispatus was a significant protective factor of late miscarriage (OR 0.20; 95% CI 0.04 to 0.99).
Conclusion. The undertaken analysis revealed significant associations of a number of anamnestic and microbiological predictor factors with miscarriage, which will enable to substantiate approaches for predicting pregnancy outcomes at different gestational age and to develop methods of pre-conception care and treatment in women with different risk of miscarriage.
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Burgoyne, M., R. Clouston, A. Banerjee, J. Fraser, and P. Atkinson. "LO01: What presenting features predict obstetrical outcomes in women who present to the emergency department with early pregnancy bleeding?" CJEM 22, S1 (May 2020): S6—S7. http://dx.doi.org/10.1017/cem.2020.57.
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Introduction: Vaginal bleeding in early pregnancy is a common emergency department (ED) presentation, with many of these episodes resulting in poor obstetrical outcome. These outcomes have been extensively studied, but there have been few evaluations of what variables are associated predictors. This study aimed to identify predictors of less than optimal obstetrical outcomes for women who present to the ED with early pregnancy bleeding. Methods: A regional centre health records review included pregnant females who presented to the ED with vaginal bleeding at <20 weeks gestation. This study investigated differences in presenting features between groups with subsequent optimal outcomes (OO; defined as a full-term live birth >37 weeks) and less than optimal outcomes (LOO; defined as a miscarriage, stillbirth or pre-term live birth). Predictor variables included: maternal age, gestational age at presentation, number of return ED visits, socioeconomic status (SES), gravida-para-abortus status, Rh status, Hgb level and presence of cramping. Rates and results of point of care ultrasound (PoCUS) and ultrasound (US) by radiology were also considered. Results: Records for 422 patients from Jan 2017 to Nov 2018 were screened and 180 patients were included. Overall, 58.3% of study participants had a LOO. The only strong predictor of outcome was seeing an Intra-Uterine Pregnancy (IUP) with Fetal Heart Beat (FHB) on US; OO rate 74.3% (95% CI 59.8-88.7; p < 0.01). Cramping (with bleeding) trended towards a higher rate of LOO (62.7%, 95% CI 54.2-71.1; p = 0.07). SES was not a reliable predictor of LOO, with similar clinical outcome rates above and below the poverty line (57.5% [95% CI 46.7-68.3] vs 59% [95% CI 49.3-68.6] LOO). For anemic patients, the non-live birth rate was 100%, but the number with this variable was small (n = 5). Return visits (58.3%, 95% CI 42.2-74.4), previous abortion (58.8%, 95% CI 49.7-67.8), no living children (60.2%, 95% CI 50.7-69.6) and past pregnancy (55.9%, 95% CI 46.6-65.1) were not associated with higher rates of LOO. Conclusion: Identification of a live IUP, anemia, and cramping have potential as predictors of obstetrical outcome in early pregnancy bleeding. This information may provide better guidance for clinical practice and investigations in the emergency department and the predictive value of these variables support more appropriate counseling to this patient population.
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Mujaibel, K., D. Farquharson, and R. D. Wilson. "Predictors of Pregnancy Outcome in Renal transplant Recipients." Journal SOGC 23, no. 10 (October 2001): 939–44. http://dx.doi.org/10.1016/s0849-5831(16)30862-x.
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Lee, G. "OP10.05: Predictors of pregnancy outcome for emergency cerclage." Ultrasound in Obstetrics & Gynecology 46 (September 2015): 81–82. http://dx.doi.org/10.1002/uog.15193.
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Umarsingh, Shalini, Jamila Khatoon Adam, and Suresh Babu Naidu Krishna. "The relationship between anti-Müllerian hormone (AMH) levels and pregnancy outcomes in patients undergoing assisted reproductive techniques (ART)." PeerJ 8 (December 22, 2020): e10390. http://dx.doi.org/10.7717/peerj.10390.
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A variety of predictors are available for ovarian stimulation cycles in assisted reproductive technology (ART) forecasting ovarian response and reproductive outcome in women including biomarkers such as anti- Müllerian hormone (AMH). The aim of our present study was to compare the relationship between AMH levels and pregnancy outcomes in patients undergoing intra-cytoplasmic sperm injection (ICSI). Overall, fifty patients (n = 50), aged 20–45 years were recruited for the present prospective study. Three AMH levels were presented with high often poly cystic ovarian syndrome (PCOS) amongst 52.4% patients, 40.5% in normal and 7.1% in low to normal, correspondingly. There was statistically significant relationship between AMH and day of embryo transfer (p < 0.05). The Pearson analysis between AMH, age, E2 and FSH displayed no statistically significant relationship between E2 and AMH (p < 0.05) and negative correlation between FSH and age (p > 0.05). The area under the receiver operating characteristic curve for E2 was 0.725 and for AMH levels as predictors of CPR was 0.497 indicating E2 as better predictor than AMH. The number of oocytes, mature oocytes and fertilized oocytes all presented a weak positive relationship to AMH. Our results confirm the clinical significance of AMH to accurately predict ovarian reserve as a marker and its limitations to use as predictor for a positive pregnancy outcome. Additional prospective studies should be conducted to validate the predictive capability of AMH levels for the outcome of clinical pregnancy.
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De Carolis, Sara, Angela Botta, Stefania Santucci, Serafina Garofalo, Carmelinda Martino, Alessandra Perrelli, Silvia Salvi, Sergio Ferrazzani, Leonardo Caforio, and Giovanni Scambia. "Predictors of Pregnancy Outcome in Antiphospholipid Syndrome: A Review." Clinical Reviews in Allergy & Immunology 38, no. 2-3 (June 27, 2009): 116–24. http://dx.doi.org/10.1007/s12016-009-8144-z.
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Syoum, Fisseha Hailemariam, Girmatsion Fisseha Abreha, Dessalegn Massa Teklemichael, and Mebrahtu Kalayu Chekole. "Fetomaternal Outcomes and Associated Factors among Mothers with Hypertensive Disorders of Pregnancy in Suhul Hospital, Northwest Tigray, Ethiopia." Journal of Pregnancy 2022 (November 9, 2022): 1–9. http://dx.doi.org/10.1155/2022/6917009.
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Background. Hypertensive disorder of pregnancy is the leading cause of maternal and perinatal morbidity and mortality worldwide and the second cause of maternal mortality in Ethiopia. The current study is aimed at assessing fetal-maternal outcomes and associated factors among mothers with hypertensive disorders of pregnancy complication at Suhul General Hospital, Northwest Tigray, Ethiopia, 2019. Methods:A hospital-based cross-sectional study was conducted from Oct. 1st, 2019, to Nov. 30, 2019, at Suhul General Hospital women’s chart assisted from July 1st, 2014, to June 31st, 2019. Charts were reviewed consecutively during five years, and data were collected using data abstraction format after ethical clearance was assured from the Institutional Review Board of Mekelle University College of Health Sciences. Data were entered into Epi-data 3.5.3 and exported to SPSS 22 for analysis. Bivariable and multivariable analyses were done to ascertain fetomaternal outcome predictors. Independent variables with p value < 0.2 for both perinatal and maternal on the bivariable analysis were entered in multivariable logistic regression analysis and the level of significance set at p value < 0.05. Results. Out of 497 women, 328 (66%) of them were from rural districts, the mean age of the women was 25.94 ± 6.46 , and 252 (50.7%) were para-one. The study revealed that 252 (50.3%) newborns of hypertensive mothers ended up with at least low Apgar score 204 (23.1%), low birth weight 183 (20.7%), preterm gestation 183 (20.7%), intensive care unit admissions 90 (10.2%), and 95% CI (46.1% -54.9%), and 267 (53.7%) study mothers also developed maternal complication at 95% (49.3-58.1). Being a teenager ( AOR = 1.815 : 95 % CI = 1.057 − 3.117 ), antepartum-onset hypertensive disorders of pregnancy ( AOR = 7.928 : 95 % CI = 2.967 − 21.183 ), intrapartum-onset hypertensive disorders of pregnancy ( AOR = 4.693 : 95 % CI = 1.633 − 13.488 ), and low hemoglobin level ( AOR = 1.704 : 95 % CI = 1.169 − 2.484 ) were maternal complication predictors; rural residence ( AOR = 1.567 : 95 % CI = 1.100 − 2.429 ), antepartum-onset hypertensive disorders of pregnancy ( AOR = 3.594 : 95 % , CI = 1.334 − 9.685 ), and intrapartum-onset hypertensive disorders of pregnancy ( AOR = 3.856 : 95 % CI = 1.309 − 11.357 ) were predictors of perinatal complications. Conclusions. Hypertensive disorder during pregnancy leads to poor fetomaternal outcomes. Teenage age and hemoglobin levels were predictors of maternal complication. A rural resident was the predictor of poor perinatal outcome. The onset of hypertensive disorders of pregnancy was both maternal and perinatal complication predictors. Quality antenatal care services and good maternal and childcare accompanied by skilled healthcare providers are essential for early detection and management of hypertensive disorder of pregnancy.
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Xie, Xinglei, Jiaming Liu, Isabel Pujol, Alicia López, María José Martínez, Apolonia García-Patterson, Juan M. Adelantado, Gemma Ginovart, and Rosa Corcoy. "Inadequate Weight Gain According to the Institute of Medicine 2009 Guidelines in Women with Gestational Diabetes: Frequency, Clinical Predictors, and the Association with Pregnancy Outcomes." Journal of Clinical Medicine 9, no. 10 (October 18, 2020): 3343. http://dx.doi.org/10.3390/jcm9103343.
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Background: In the care of women with gestational diabetes mellitus (GDM), more attention is put on glycemic control than in factors such as gestational weight gain (GWG). We aimed to evaluate the rate of inadequate GWG in women with GDM, its clinical predictors and the association with pregnancy outcomes. Methods: Cohort retrospective analysis. Outcome variables: GWG according to Institute of Medicine 2009 and 18 pregnancy outcomes. Clinical characteristics were considered both as GWG predictors and as covariates in outcome prediction. Statistics: descriptive, multinomial and logistic regression. Results: We assessed 2842 women diagnosed with GDM in the 1985–2011 period. GWG was insufficient (iGWG) in 50.3%, adequate in 31.6% and excessive (eGWG) in 18.1%; length of follow-up for GDM was positively associated with iGWG. Overall pregnancy outcomes were satisfactory. GWG was associated with pregnancy-induced hypertension, preeclampsia, cesarean delivery and birthweight-related outcomes. Essentially, the direction of the association was towards a higher risk with eGWG and lower risk with iGWG (i.e., with Cesarean delivery and excessive growth). Conclusions: In this cohort of women with GDM, inadequate GWG was very common at the expense of iGWG. The associations with pregnancy outcomes were mainly towards a higher risk with eGWG and lower risk with iGWG.
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Lapshtaeva, A. V., I. V. Sychev, and L. N. Goncharova. "Laboratory predictors of pregnancy in vitro fertilization." Russian Clinical Laboratory Diagnostics 66, no. 5 (May 23, 2021): 291–96. http://dx.doi.org/10.51620/0869-2084-2021-66-5-291-296.
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Identification of factors determining both of favorable and unfavorable outcome of IVF will increase the effectiveness of this method and optimize infertility treatment. The aim of the research is to analyze the correlation between serum IL-1α concentration, its gene rs1800587 (C/T) genotype carrier and thyroid-stimulating hormone (TSH), thyroid hormones (triiodothyronine (T3) and tetraiodothyronine (T4)), and evaluate the prognostic significance of their combinations in women with tube-peritoneal infertility under the IVF program. 120 patients with tube-peritoneal infertility who applied for an IVF program were examined. Depending on the outcome of the procedure, 2 groups of patients were allocated: 1 group - 40 women who had a pregnancy after IVF, 2 group - 80 patients who did not have a pregnancy. The content of IL-1α, TSH, T3, T4 was determined in blood by ELISA. Genotyping was performed on the rs1800587 (C/T) polymorphic marker of the IL-1α gene. TSH, T3, T4 were within the norm for both groups. In our study, women with a TSH concentration of 0.23 to 1.7 nmol/L had a chance of a favorable IVF outcome 1.4 times higher than with other TSH levels (p = 0.042901); with a T3 level of 1.0 to 1.8 nmol/L had a chance of becoming pregnant 5.7 times higher than with other levels of T3 (p = 0.00002). For T4 concentration, the confidence test was not achieved (p = 0.068505). The individual indicators of IL-1α, TSH, T3 and carrier of the genotype of the gene IL-1α at the preconceptive stage have lower diagnostic value than their combined combination. Three combinations have maximum predictive value: a combination of the T/T genotype of the IL-1α gene and the TSH level of 0.23 to 1.7 nmol/l - OR = 8.1 (p = 0.000048); combination of IL-1α of 28.7 to 85.1 pg/ml, T/T gene genotype IL-1α and TSH level of 0.23 to 1.7 nmol/l - OR = 8.1 (p = 0.000048); combination of IL-1α of 28.7 to 85.1 pg/ml, T/T gene genotype IL-1α, TSH level of 0.23 to 1.7 nmol/l and T3 level of 1.0 to 1.8 nmol/l - OR = 8.1 (p = 0.000146). Thus, proposed new prognostic markers of IVF program effectiveness.
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Rottenstreich, A., S. Fridman Lev, R. Rotem, T. Mishael, B. Koslowsky, E. Goldin, S. Grisaru-Granovsky, and A. Bar-Gil Shitrit. "P242 Prior pregnancy outcome is an important determinant of subsequent pregnancy outcome in women with inflammatory bowel diseases." Journal of Crohn's and Colitis 14, Supplement_1 (January 2020): S266—S267. http://dx.doi.org/10.1093/ecco-jcc/jjz203.371.
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Abstract Background Inflammatory bowel diseases (IBD) are commonly diagnosed in women of childbearing age. As such, pregnancy is often encountered in this subset of patients. Disease flare throughout gestation are not uncommon and can substantially affect pregnancy outcomes. We aimed at the effect of prior pregnancy outcome on the risk of disease flare at subsequent pregnancy in women with IBD. Methods Women with IBD attending a multidisciplinary clinic for the preconception, antenatal and postnatal treatment were prospectively recruited during 2011–2018. Results Overall, 476 IBD women were followed during the study period. Of them, 69 (14.5%) had two pregnancies throughout the follow-up period and constituted the study cohort. Among these 69 women, 48 (69.6%) had Crohn’s disease and 21 (30.4%) ulcerative colitis. The median interpregnancy interval was 20 [11–32] months. Overall, 34 (49.3%) women experienced disease flare at the subsequent pregnancy. In multivariate analysis, active disease at conception (odds ratio [95% CI]: 25.65 (3.05, 215.52), p < 0.001) and history of disease flare at the previous pregnancy (odds ratio [95% CI]: 4.21 (1.10, 16.58), p < 0.001) were the only independent predictors of disease relapse in current gestation. Rates of hospitalisation during pregnancy (14.7% vs. 0, p = 0.02) and preterm delivery (32.4% vs. 5.7%, p = 0.006) were higher, and neonatal birth weight was lower (median 3039 vs. 3300 grams, p = 0.03), in those with disease flare as compared with those with maintained remission. Conclusion History of disease relapse at previous gestation and periconception disease activity were found as an important predictor of disease flare among IBD women. These data would facilitate adequate counselling and informed management decisions among reproductive-aged IBD women and their treating physicians.
Dissertations / Theses on the topic "Pregnancy outcome predictors"
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Ma, Xue Jie. "Perinatal complications as predictors of neuropsychological outcome in children with learning disabilities." Virtual Press, 1996. http://liblink.bsu.edu/uhtbin/catkey/1036813.
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A prospective study was conducted on a group of 160 students from 9 to 14 years of age with learning disabilities to predict neuropsychological outcome using perinatal information as predictors. Perinatal information was obtained from the Maternal Perinatal Scale (MPS) (Dean & Gray, 1985). Subjects' neuropsychological functioning was assessed by the Short Neuropsychological Screening Device (SNSD) (Reitan & Herring, 1985). Information concerning subjects' intelligence was obtained from the Wechsler Intelligence Scale for Children-III (WISC-III) administered within the past two years. Hollingshead's Four Factor Index of Social Status was employed to determine subjects' socioeconomic status. A stepwise multiple regression analysis yielded a regression model that contained a subset of 7 perinatal risk factors, involving: (1) Obstetric History; (2) Gestational Age; (3) Psychosocial Events; (4) Delivery; (5) Intrauterine Stress; (6) Teratogenic Stress; and (7) Fetal Oxygenation. A hierarchical regression analysis was further performed to examine if adding socioeconomic and intellectual information to the regression model could increase the prediction of neuropsychological outcome. Results showed that up to 82% of the variability in the neuropsychological outcome was explained by the linear composite of the 7 risk factors. When socioeconomic and intellectual information were added to the regression model, the prediction of neuropsychological outcome was significantly improved. About 201 of the students with learning disabilities in the present study were found to display symptoms similar to minimal brain damage (MBD) relating to poor visual-motor integration, underdeveloped language skills, and aphasic conditions. The results support the theory of a "continuum of reproductive casualty" proposed by Pasamanick et al. (1956). The importance of detecting early indicators of neuropsychological deficits in at risk children was further suggested by the present study.Department of Educational Psychology
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Mañé, Serra Laura. "Utilitat de la glucèmia basal i l’hemoglobina glicosilada del primer trimestre com a predictors de resultats obstètrics adversos en una població d’origen multiètnic." Doctoral thesis, Universitat Autònoma de Barcelona, 2019. http://hdl.handle.net/10803/669940.
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L’epidèmia d’obesitat i les xifres creixents de població immigrant han donat lloc a una major prevalença de diabetis mellitus tipus 2 (DM2) en dones fèrtils, amb un increment del nombre de dones embarassades amb DM2 no coneguda. Diversos estudis han constatat el paper de l’hiperglucèmia materna com a factor de risc de complicacions obstètriques, també amb nivells per sota el rang diagnòstic de diabetis, pel que el cribratge precoç de gestants amb elevat risc és essencial.
Aquest projecte pretén avaluar la utilitat de l’hemoglobina glicosilada (HbA1c) i la glucèmia plasmàtica del primer trimestre per identificar dones sense diabetis amb major risc obstètric i establir uns punts de tall per a cada col·lectiu ètnic. A partir d’una cohort prospectiva a l’Hospital del Mar entre gener de 2010 i octubre de 2016 s’han elaborat un total de quatre publicacions científiques.
Primerament es van analitzar les característiques basals i els resultats maternofetals de les dones amb DM2 no coneguda diagnosticades intragestació en comparació amb aquelles diagnosticades de diabetis gestacional (DMG). Les primeres presentaven un perfil metabòlic més advers previ, pitjor control metabòlic intragestació i majors taxes de complicacions maternofetals.
L'ús de l’HbA1c per diagnosticar diabetis intragestació s'inclou en les guies de pràctica clínica des de fa uns anys. Aquest ús s'ha limitat a establir el diagnòstic de DM2 no coneguda utilitzant els punts de tall emprats en població no gestant. Tanmateix, la relació entre els nivells d’HbA1c del primer trimestre en rang no diabètic i el risc de complicacions obstètriques no s’ha estudiat a fons. Un estudi publicat l’any 2014 suggereix que un llindar ≥5,9% identifica gestants amb major risc de resultats adversos. En el segon estudi d’aquest projecte, es va analitzar si aquest llindar podia ser un marcador de risc obstètric en la nostra població multiètnica, comprovant-se que s’associava amb un risc tres vegades major de macrosomia i preeclàmpsia.
La glucèmia plasmàtica s’utilitza, conjuntament amb l’HbA1c, per detectar DM2 no coneguda en la primera visita prenatal. En el tercer article, es va comparar l’associació entre els nivells de glucèmia plasmàtica en dejú i HbA1c del primer trimestre i els resultats maternofetals per determinar si la glucèmia plasmàtica podia ser un millor predictor de complicacions obstètriques. No es va trobar associació entre els nivells de glucèmia i cap resultat obstètric. Les dones amb una HbA1c ≥5,8% van mostrar un major risc de macrosomia, un llindar ≥5,9% es va associar a un risc tres vegades major de preeclàmpsia i ≥ 6,0% a un increment de quatre vegades el risc de gran per edat gestacional (GEG).
Finalment, es va avaluar l'associació entre els nivells d’HbA1c i els resultats maternofetals en els diferents grups ètnics, ja que prèviament s’han posat de manifest diferències racials en els nivells d’HbA1c i en la relació entre hiperglucèmia i complicacions obstètriques. No es va trobar cap associació en les gestants caucàsiques. Les dones llatinoamericanes amb HbA1c ≥5,8% presentaven major risc de macrosomia i un llindar ≥5,9% es va associar a major risc de GEG. Les dones indopaquistaneses amb HbA1c ≥5,7% van associar major risc de macrosomia i es va detectar una relació gradual contínua entre els nivells d’HbA1c i l’aparició de preeclàmpsia i GEG a partir de 5,4%.
En conclusió, el diagnòstic de DM2 no coneguda intragestació incrementa dramàticament el risc de complicacions obstètriques en comparació amb el de DMG. La determinació precoç d’HbA1c pot ajudar a millorar el cribratge de dones d'alt risc però els nivells de glucèmia plasmàtica no representen un bon marcador de risc obstètric. La utilitat de l’HbA1c difereix segons l’ètnia essent un bon marcador de risc en dones llatinoamericanes i indopaquistaneses, però no en caucàsiques.The ongoing epidemic of obesity and the rising immigration figures have led to more type 2 diabetes in women of childbearing age, with an increase in the number of pregnant women with undiagnosed type 2 diabetes. The role of maternal hyperglycaemia, even in non-diabetic range, as an independent risk factor for obstetric complications has been clearly established. Thus, early detection of women at high pregnancy risk is a desirable goal. The present research has assessed the potential utility of first-trimester glycosylated haemoglobin (HbA1c) and fasting plasma glucose (FPG) to identify non-diabetic women at increased pregnancy risk and established specific cut-off points for each ethnicity. We carried out the follow-up of a prospective cohort at Hospital del Mar between January 2010 and October 2016. A total of four scientific publications have been included. Firstly, we examined the differences in maternal characteristics and pregnancy outcomes of women diagnosed of unknown type 2 diabetes or overt diabetes (ODM) in pregnancy compared with those diagnosed of gestational diabetes mellitus (GDM). ODM women had a more adverse metabolic profile prior to pregnancy, a poorer metabolic control and higher rates of obstetric complications than GDM women. HbA1c has been recently included in clinical practice guidelines as a diagnostic tool for diabetes in pregnancy. However, its use has been limited to establishing the diagnosis of unknown type 2 diabetes using the standard criteria applied in non-pregnant population. The association between first-trimester HbA1c levels in non-diabetic range and the risk of obstetric complications has not been studied thoroughly. A study published on 2014 suggested that a 5.9% threshold could identify women with an increased risk of obstetric complications. In our second study, we aimed to evaluate whether this threshold could play a role as an obstetric risk marker in our multiethnic reference population. An HbA1c ≥5.9% was shown to be associated with a three-fold greater risk of macrosomia and preeclampsia. FPG has been used, along with HbA1c, to detect unknown type 2 diabetes at the baseline prenatal visit. In our third publication, we compared associations between first-trimester FPG and HbA1c levels and pregnancy complications to determine whether FPG could be a better predictor than HbA1c. No clinically-useful correlation between FPG levels and any adverse obstetric outcome was found. An HbA1c ≥5.8% threshold was associated with an increased risk of macrosomia, a ≥5.9% cut-off point was associated with a three-fold increased risk of preeclampsia and an HbA1c ≥6.0% was associated with a four-fold increased risk of large-for-gestational age (LGA). Finally, we examined the association of first-trimester HbA1c levels with the development of obstetric complications in the different ethnic groups of our cohort, provided that racial differences have been described in HbA1c levels and in the interrelationship between hyperglycaemia and pregnancy outcomes. There was no association with any obstetric outcome among Caucasians. Latin-American women with an HbA1c ≥5.8% showed an increased risk of macrosomia and a ≥5.9% threshold was associated with a higher risk of LGA. Among South-Central Asian women an HbA1c ≥5.7% was associated with an increased risk of macrosomia and a continuous graded relationship between rising HbA1c levels and the occurrence of preeclampsia and LGA was detected starting at values of 5.4%. In conclusion, the diagnosis of ODM during pregnancy dramatically increases the risk of obstetric complications compared to GDM. HbA1c addition in the first-trimester blood testing can help to improve the screening of high-risk women. Conversely, first-trimester FPG has not proved to be a suitable risk marker. However, the utility of first-trimester HbA1c levels differs according to ethnicity: it performs as an independent predictor of obstetric complications in Latin-American and South-Central Asian women but not among Caucasians.
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Nwi-ue, Letam. "Predictors of Poor Pregnancy Outcomes Among Pregnant Women in Island Maternity, Nigeria." ScholarWorks, 2019. https://scholarworks.waldenu.edu/dissertations/7245.
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Pregnancy outcomes have improved tremendously in developed countries. Notwithstanding, it is still a huge challenge in developing countries, especially Sub-Saharan Africa. In 2015 in Nigeria, about 145 women died daily from pregnancy-related causes. Similarly, nearly 2,300 children under 5 years were lost in the same year. Nigeria consistently underperformed in some of the critical pregnancy indicators such as maternal and neonatal mortality, second worst only to India in the world. Studies on poor pregnancy outcomes are scarce in Nigeria. The purpose of this quantitative, retrospective cross-sectional study was to use local evidence to ascertain the risk factors that predict poor pregnancy outcomes for women of childbearing age (15-49 years old) in Nigeria. The theoretical framework for this study was the social cognitive theory. Secondary data from 400 pregnant women from Island Maternity Hospital, Nigeria, was used for this study. Five central research questions were analyzed through univariate and multiple logistic regressions. The results indicated moderate to strong statistically significant associations between outcomes of last pregnancy, gestational age at delivery, mode of delivery, and the timing of antenatal care booking with maternal mortality, neonatal mortality, and low birth weight, even after controlling for other covariates. Findings from this study may foster positive social change by further enhancing the understanding of poor pregnancy outcomes, especially in Nigeria. It will help public health practitioners, policymakers, community leaders and other stakeholders to design strategies and interventions that will take advantage of cultural and religious norms and educational status of women of childbearing age in promoting reproductive health in Nigeria.
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Ayoola, Adejoke Bolanle. "Timing of pregnancy recognition as a predictor of prenatal care initiation and birth outcomes." Diss., Connect to online resource - MSU authorized users, 2007.
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Cheong-See, Fi. "Predictors for adverse maternal and fetal outcomes in high risk pregnancy." Thesis, Queen Mary, University of London, 2017. http://qmro.qmul.ac.uk/xmlui/handle/123456789/25811.
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This thesis aims to undertake health technology assessments in high risk pregnancies through the following objectives: 1. In women with pre-eclampsia, a) To evaluate the association of maternal genotype and severe pre-eclampsia b) To assess the accuracy of tests in predicting adverse pregnancy outcomes c) To develop composite outcomes for reporting in trials on late onset pre-eclampsia 2. In women with multiple pregnancy, a) To study the association between chorionicity and stillbirth b) To identify the optimal timing of delivery in monochorionic and dichorionic twin pregnancies 3. In the field of prediction research in obstetrics a) To provide an overview of the existing prognostic models and their qualities b) To evaluate the methodological challenges and potential solutions in developing a prognostic model for complications in pre-eclampsia Methods The following research methodologies were used: Delphi survey, systematic reviews and meta-analyses. Results 1. a) Maternal genotype and severe pre-eclampsia: 57 studies evaluated 50 genotypes; increased risk of severe pre-eclampsia with thromobophilic genes. b) Accuracy of tests in predicting pre-eclampsia complications: 37 studies evaluated 13 tests. No single test showed high sensitivity and specificity. c) Delphi survey of 18/20 obstetricians and 18/24 neonatologists identified clinically important maternal and neonatal outcomes and maternal and neonatal composite outcomes were developed. 2. Prospective risk of stillbirth and neonatal deaths in uncomplicated monochorionic and dichorionic twin pregnancies: 32 studies were included. In dichorionic twin pregnancies, the risk of stillbirths was balanced against neonatal death at 37 weeks' gestation. In monochorionic pregnancies, there was a trend towards increase in stillbirths after 36 weeks but this was not significant. 3. a) From 177 studies included, 263 obstetric prediction models were developed for 40 different outcomes, most commonly pre-eclampsia, preterm delivery, mode of delivery and small for gestational age neonates. b) The obstetric prognostic model challenge of dealing with treatment paradox was explored and seven potential solutions proposed by expert consensus. Conclusion I have identified the strength of association for genes associated with complications in pre-eclampsia, components for composite outcomes for reporting in studies on pre-eclampsia, and the optimal timing of delivery for twin pregnancies. My work has highlighted the gaps in prediction research in obstetrics and the limitations of individual tests in pre-eclampsia.
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Kazim, Nahla. "Evaluation of hyperglycosylated hCG as a predictor of adverse pregnancy outcome." Thesis, University of Edinburgh, 2010. http://hdl.handle.net/1842/24758.
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Hyperglycosylated human chorionic gonadotrophin (HhCG) is a glycoprotein hormone that reportedly has biological functions different from those of hCG. It is produced by invasive cytotrophoblast cells at the time of implantation and in gestational trophoblastic disease. The invasion of cytotrophoblasts and their regulated proliferation are major determinants of pregnancy outcome: a shift of these controlling mechanisms has been associated with adverse pregnancy complications. Altered levels of HhCG may mirror placental dysfunction or impaired placental differentiation. This observational cohort study was undertaken to correlate various pregnancy outcomes with serum and urinary concentrations of HhCG and other hCG molecular forms, in order to determine whether HhCG is a helpful predictor of adverse pregnancy outcome. The first cohort included 287 women with spontaneous conceptions who attended the Obstetrics and Gynaecology Department of Mafraq Hospital in the United Arab Emirates. Paired serum and urine samples were collected on a single occasion from singleton pregnancies between 6 and 24 weeks of gestation. Patients were followed up until the pregnancy outcome was available. HhCG levels in pregnancies with uneventful outcomes and those with pregnancy complications were compared. Significantly lower HhCG levels were observed for pregnancies resulting in miscarriage as compared with late pregnancy complications. In the second cohort of 128 patients undergoing in vitro fertilisation or intracytoplasmic sperm injection at the Assisted Conception Unit in Edinburgh, the usefulness of serum HhCG levels on Day 14 of oocyte retrieval was assessed. HhCG levels were found to be significantly lower in pregnancies ending in spontaneous miscarriages and biochemical pregnancies. The potential diagnostic and prognostic utility of HhCG was confirmed by a receiver operating characteristic curve plot. The sugar chain heterogeneity of hCG from various sources was also investigated by SDS-PAGE and immunoblot analyses of pregnancy urine samples to assess their potential value as new diagnostic tools for predicting pregnancy outcome. Using monoclonal antibodies and a panel of lectins that can separate N- from O-linked sugar chains, variations in the hCG glycosylation patterns during different stages of pregnancy and pregnancy complication were studied. While the differences in the hCG glycosylation profiles reported here are interesting, whether they can helpfully contribute to the prediction of pregnancy outcome requires further study.
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Clements, Andrea D., Wallace E. Jr Dixon, and J. Gorneiwicz. "Maternal Temperament as a Predictor of Pregnancy, Birth, and Breastfeeding Outcomes." Digital Commons @ East Tennessee State University, 2007. https://dc.etsu.edu/etsu-works/7288.
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Janis, Beth M. "Prevalence and Predictors of Perinatal Mental Health Outcomes." Thesis, University of North Texas, 2015. https://digital.library.unt.edu/ark:/67531/metadc801915/.
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Prior research has identified risk factors that may contribute to the development of maternal stress reactions following childbirth. Specifically, situational factors (e.g., factors associated with childbirth), individual factors, and personality factors, have been explored in a multitude of prior studies. The current study sought to build upon this literature by examining both risk and resilience in a sample of both mothers and fathers via a prospective longitudinal investigation. Baseline assessment of expectant parents occurred prior to the birth of their child, with additional assessment at approximately 1, 6, and 9 weeks post-childbirth. A total of 50 participants completed all four of these assessments. Results indicated approximately 20% (n = 10) of participants endorsed moderate or greater stress symptoms after birth, while 22% (n = 11) also exhibited symptoms of moderate or greater depressive symptoms. Stress reactions were assessed with the Perinatal Posttraumatic Stress Disorder Questionnaire (PPQ); validity analyses indicated the PPQ had significantly stronger correlations with convergent measures than discriminant measures. Additionally, participants were randomized into one of two post-delivery study arms: an expressive writing group or an active control group. Although expressive writing results were inconclusive, there was a general effect of time, which may be reflective of a natural recovery process. Given the prevalence of stress and depressive reactions in this sample, and the population, exploration into feasible and accessible treatment interventions is warranted. While these results also suggest a potential natural recovery for some participants, interventions for support in the short-term timeframe after childbirth may continue to be useful.
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Kinney, Sharyl Kidd. "Maternal participation in WIC and Children First as a predictor of birth weight." Oklahoma City : [s.n.], 2010.
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Teixeira, Cláudia Sofia Morais. "Metabolic syndrome in pregnancy as a predictor of adverse obstetric and neonatal outcomes." Master's thesis, Instituto de Ciências Biomédicas Abel Salazar, 2008. http://hdl.handle.net/10216/20993.
Full textBooks on the topic "Pregnancy outcome predictors"
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Costa, D. Da. A prospective study of psychosocial predictors of reproductive outcome in younger and older pregnant women. Montréal, Québec: Sexuality and Reproductive Health Lab, Dept. of Psychology, Concordia University, 1995.
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Lorenzano, Svetlana, and Danilo Toni. Acute treatment. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780198722366.003.0014.
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Young adults may benefit from intravenous thrombolysis with tissue plasminogen activator and the treatment is safe. Several important outcome predictors have been identified and can be used for an optimal selection of eligible patients. Intravenous thrombolysis should not be denied a priori in patients with stroke due to craniocervical artery dissection or illicit drug use, or young menstruating/pregnant women. It is recommended to discuss treatment risks and benefits and decisions should be made on an individual basis. Young patients may benefit from endovascular treatment despite larger infarcts. In case of malignant middle cerebral artery infarction, decompressive hemicraniectomy should be considered. Due to under-representation of young patients in past randomized controlled trials, analyses from these trials and prospective studies on this age group are needed.
Book chapters on the topic "Pregnancy outcome predictors"
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Anumba, Dilly OC, and Shamanthi M. Jayasooriya. "Prenatal Risk Assessment for Preterm Birth in Low-Resource Settings: Demographics and Obstetric History." In Evidence Based Global Health Manual for Preterm Birth Risk Assessment, 15–23. Cham: Springer International Publishing, 2022. http://dx.doi.org/10.1007/978-3-031-04462-5_3.
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AbstractMaternal demographics and past obstetric history provide important information regarding the risk of preterm birth. Careful assessment for these factors at pregnancy registration is crucial for preterm birth risk assessment and signposting of care to mitigate preterm birth where possible. Demographic factors evidenced to increase the risk of PTB include extremes of maternal age, black ethnicity, and history of domestic abuse. Obstetric risk factors include a history of previous preterm birth, late miscarriage, stillbirth, cervical surgery, or uterine variants. In an index pregnancy, multiple pregnancy is a main predictor of preterm birth. Early pregnancy risk assessment for these factors can inform generic measures aimed at mitigating the occurrence and consequences of preterm birth. Importantly, further risk assessment and surveillance, including where possible assessment of the cervix for shortening by transvaginal ultrasound, can inform antenatal care to optimise birth outcomes, by referral to a preterm birth prevention or high risk pregnancy service, or offering cervical cerclage or progesterone supplementation.
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Fadeeva, Tat'iana Sergeevna. "Connective tissue dysplasia: new horizons of the problem." In Дисплазия соединительной ткани: новые горизонты проблемы. Publishing house Sreda, 2019. http://dx.doi.org/10.31483/r-22132.
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The work raises questions of predicting the complications of pregnancy and childbirth and adverse conditions in the fetus in the presence of UCTD in the expectant mother, who also need to be studied, especially from the standpoint of mathematical modeling of the disease. It is also necessary to develop a common tactic for providing medical and social assistance and treatment and diagnostic services to pregnant women suffering from UCTD, which will make the outcome of childbirth more favorable and improve the subsequent prognosis for mother and newborn. In the literature there is practically no assessment of the course of pregnancy and the outcome of childbirth, depending on the severity of UCTD. Little is known about the role of a connective tissue metabolism marker - hydroxyproline, trace elements (magnesium) and vitamins (D3) in pregnant women suffering from UCTD, and the medical tactics regarding such patients are not clearly defined. Despite numerous successes in the study of the causes of complications during pregnancy and childbirth in women suffering from UCTD, a unified approach to their management during the prenatal stage has not yet been developed. Therefore, the search for possible predictors for the timely prediction of adverse pregnancy and childbirth outcome in such patients is becoming increasingly important. This will make it possible to develop an optimal organizational and methodological base and subsequently improve the prognosis for women and their offspring. Thus, in contrast to the existing standard approach, we have proposed a comprehensive management of patients suffering from UCTD, including the timely identification of patients from the risk group, clarification of their condition using such markers as magnesium and hydroxyproline, additional intake of magnesium and vitamin D preparations. Optimal plan managing the period of gestation, childbirth, and a pathogenetically reasoned set of treatment and preventive measures for women with UCTD, will not only improve the outcomes of pregnancy and childbirth, but also contribute to the health of the future generation. 1. UCTD affects the course of pregnancy, childbirth and the condition of the newborn. The degree of exposure is largely determined by the severity of the underlying disease. In severe UCTD, the prevalence of spontaneous miscarriage and preterm labor was significantly higher, and endometritis and severe anemia were more common in the postpartum period. Severe asphyxia on the Apgar scale at the 1st and 5th minutes, congenital heart defects, morphofunctional immaturity, conjugation jaundice and convulsive syndrome were more common in the fetus. 2. A low content of magnesium and hydroxyproline is associated with the occurrence of complications during childbirth and a decrease in the anthropometric characteristics of the newborn. Taking magnesium preparations reliably affects the concentration of this trace element and hydroxyproline in the blood of pregnant women suffering from UCTD. 3. Therapy with magnesium preparations is an effective tool in patients suffering from UCTD, as it helps to improve well-being during pregnancy, improves the course of the postpartum period and reduces the prevalence of chronic fetal hypoxia. 4. Vitamin D and magnesium supplements have a beneficial effect on pregnancy and the fetus, reducing the prevalence of pre-eclampsia and chronic intrauterine hypoxia of the fetus, reducing the incidence of morphofunctional immaturity and conjugation jaundice of the newborn. 5. The created computer program “STEP DST” can be applied in the clinical practice of obstetrician-gynecologists and health care organizers. The obtained individual forecast of the probability of development of complications of reproduction allows us to outline the optimal plan for managing the period of gestation, childbirth and the postpartum period, to prescribe a pathogenetically based set of therapeutic and preventive measures for women suffering from UCTD.
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Ancuta, Eugen, Dragos Valentin Crauciuc, Emil Anton, Carmen Anton, Eduard Crauciuc, Dumitru Sofroni, Larisa Sofroni, Claudia Mihailov, and Codrina Ancuta. "Challenges in the Delivery Room: Integrated Analysis of Biomarkers Predicting Complications in Lupus Pregnancy." In Midwifery [Working Title]. IntechOpen, 2021. http://dx.doi.org/10.5772/intechopen.96099.
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Pregnancy in autoimmune rheumatic diseases remains a real challenge in clinical practice due to complex interplay between disease activity, pregnancy and drugs, and account for potential influence of pregnancy on rheumatic condition and the impact of disease on pregnancy outcomes. Indeed, innovative and successful therapies have dramatically improved the quality of life in immune-mediated rheumatic conditions and, subsequently, allowed more patients of reproductive age to plan a pregnancy/to conceive. The purpose of this chapter is to discuss emerging data about the interaction of pregnancy and systemic erythematosus lupus (SLE) focusing on modulation of the immune system by pregnancy, pregnancy outcomes in women with active lupus, biomarkers of adverse pregnancy outcomes (APO) including predictors of pre-eclampsia, predictors of obstetric complications in SLE, the influence of autoantibodies on fetal health, and, finally, evidence about rheumatologic and obstetric follow-up. There are still unmet needs in this new field of reproductive rheumatology and it becomes crucial that researchers, physicians (rheumatologists, specialists in maternofetal medicine, obstetricians) and midwifes share their knowledge and expertise in counseling women with SLE wishing to conceive, assisting pregnancy and managing different issues related to APO as well as drug optimization in preconception, during pregnancy and postpartum period.
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Fernandes, Melissa, Vera Bernardino, Anna Taulaigo, Jorge Fernandes, Ana Lladó, and Fátima Serrano. "Systemic Lupus Erythematosus Pregnancy." In Lupus - Need to Know. IntechOpen, 2021. http://dx.doi.org/10.5772/intechopen.99008.
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Systemic Lupus Erythematosus (SLE) is an autoimmune disease of unknown etiology that often affects women during childbearing age. Pregnant women with SLE are considered high-risk patients, with pregnancy outcomes being complicated by high maternal and fetal mortality and morbidity. Obstetric morbidity includes preterm birth, fetal growth restriction (FGR), and neonatal lupus syndromes. Active SLE during conception is a strong predictor of adverse pregnancy outcomes and exacerbations of disease can occur more frequently during gestation. Therefore, management of maternal SLE should include preventive strategies to minimize disease activity and to reduce adverse pregnancy outcomes. Patients with active disease at time of conception have increased risk of flares, like lupus nephritis, imposing a careful differential diagnosis of pre-eclampsia, keeping in mind that physiological changes of pregnancy may mimic a lupus flare. Major complications arise when anti-phospholipid antibodies are present, like recurrent pregnancy loss, stillbirth, FGR, and thrombosis in the mother. A multidisciplinary approach is hence crucial and should be initiated to all women with SLE at childbearing age with an adequate preconception counseling with assessment of risk factors for adverse maternal and fetal outcomes with a tight pregnancy monitoring plan. Although treatment choices are limited during pregnancy, prophylactic anti-aggregation and anticoagulation agents have proven beneficial in reducing thrombotic events and pre-eclampsia related morbidity. Pharmacological therapy should be tailored, allowing better outcomes for both the mother and the baby. Immunosuppressive and immunomodulators, must be effective in controlling disease activity and safe during pregnancy. Hydroxychloroquine is the main therapy for SLE due to its anti-inflammatory and immunomodulatory effects recommended before and during pregnancy and other immunosuppressive drugs (e.g. azathioprine and calcineurin inhibitors) are used to control disease activity in order to improve obstetrical outcomes. Managing a maternal SLE is a challenging task, but an early approach with multidisciplinary team with close monitoring is essential and can improve maternal and fetal outcomes.
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Patrick, Stephen W., Judith Dudley, Peter R. Martin, Frank E. Harrell, Michael D. Warren, Katherine E. Hartmann, E. Wesley Ely, Carlos G. Grijalva, and William O. Cooper. "Prescription Opioid Epidemic and Infant Outcomes." In Opioid Addiction, 78–89. American Academy of Pediatrics, 2018. http://dx.doi.org/10.1542/9781610022798-infant_outcomes.
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BACKGROUND AND OBJECTIVES Although opioid pain relievers are commonly prescribed in pregnancy, their association with neonatal outcomes is poorly described. Our objectives were to identify neonatal complications associated with antenatal opioid pain reliever exposure and to establish predictors of neonatal abstinence syndrome (NAS). METHODS We used prescription and administrative data linked to vital statistics for mothers and infants enrolled in the Tennessee Medicaid program between 2009 and 2011. A random sample of NAS cases was validated by medical record review. The association of antenatal exposures with NAS was evaluated by using multivariable logistic regression, controlling for maternal and infant characteristics. RESULTS Of 112 029 pregnant women, 31 354 (28%) filled ≥1 opioid prescription. Women prescribed opioid pain relievers were more likely than those not prescribed opioids (P < .001) to have depression (5.3% vs 2.7%), anxiety disorder (4.3% vs 1.6%) and to smoke tobacco (41.8% vs 25.8%). Infants with NAS and opioid-exposed infants were more likely than unexposed infants to be born at a low birth weight (21.2% vs 11.8% vs 9.9%; P < .001). In a multivariable model, higher cumulative opioid exposure for short-acting preparations (P < .001), opioid type (P < .001), number of daily cigarettes smoked (P < .001), and selective serotonin reuptake inhibitor use (odds ratio: 2.08 [95% confidence interval: 1.67–2.60]) were associated with greater risk of developing NAS. CONCLUSIONS Prescription opioid use in pregnancy is common and strongly associated with neonatal complications. Antenatal cumulative prescription opioid exposure, opioid type, tobacco use, and selective serotonin reuptake inhibitor use increase the risk of NAS.
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Correa, Núria, Rita Vassena, Jesús Cerquides, and Josep Lluís Arcos. "Limits of Conventional Machine Learning Methods to Predict Pregnancy and Multiple Pregnancy After Embryo Transfer." In Frontiers in Artificial Intelligence and Applications. IOS Press, 2021. http://dx.doi.org/10.3233/faia210141.
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When training models to learn the relationship between two or more variables, we expect to see previously demonstrated knowledge about that relationship reflected in the resulting estimators. For some domains, such as healthcare, it is imperative for actual implementation of those models that their predictions respect this knowledge. In this study we focus on Assisted Reproduction Technology (ART), the subspecialty of gynecology occupied with treating human infertility, and where the goal of any treatment is the delivery of a healthy newborn. A common ART treatment is In vitro Fertilization (IVF), where embryos are generated in vitro from collected sperm and oocytes, and transferred to the uterus of the patient after selecting those most likely to give rise to a healthy pregnancy. IVF has an approximate 30% successes rate per cycle; to palliate for this low success rate, a common practice so far has been to transfer two embryos simultaneously, aiming to increase the chances of a favorable outcome. While increasing overall live birth rates, this method has also led to an alarmingly high rate of twin and triplet births, associated with four times higher risk of perinatal mortality and increased obstetric complications. Our objective is to predict the chances of both pregnancy (P) and multiple pregnancy (MP) following either single embryo transfer (SET) or double embryo transfer (DET), and in so facilitating an informed decision on how many embryos to transfer. From existing literature, it is known that: (1) it is not possible for the chances of both P and MP to be decreased by increasing the number of embryos; (2) MP chances cannot be higher than P; and (3) chances of pregnancy are highly correlated with age, embryo stage, and quality. With a dataset generated from an existing observational study, we trained several state-of-the-art classifiers to predict P and MP given SET and DET. Analyzing the results, all classifiers achieved promising AUC scores. However, Random Forest and Gradient Boosting predicted negative chance differences in many instances when increasing the number of embryos infringing the first constraint. Logistic Regression predicted always positive differences, but in some instances it infringes the second constraint, predicting higher chances of MP than of P. Moreover, it showed little to no variation across ages or embryo stages violating third constraint. Conventional Machine Learning models struggle to reflect the real-world outcomes when using DET versus SET in specific patients. More informative variables could help, but it is already worrisome that variables as important as age and embryo stage do not result already in any variation, and that when models do show variation, in many cases they predicted decreasing chances of success with more embryos. We conclude that new and different approaches are needed to correctly model this scenario and, likely, many others resembling this one.
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Correa, Núria, Rita Vassena, Jesús Cerquides, and Josep Lluís Arcos. "Limits of Conventional Machine Learning Methods to Predict Pregnancy and Multiple Pregnancy After Embryo Transfer." In Frontiers in Artificial Intelligence and Applications. IOS Press, 2021. http://dx.doi.org/10.3233/faia210141.
Full textAbstract:
When training models to learn the relationship between two or more variables, we expect to see previously demonstrated knowledge about that relationship reflected in the resulting estimators. For some domains, such as healthcare, it is imperative for actual implementation of those models that their predictions respect this knowledge. In this study we focus on Assisted Reproduction Technology (ART), the subspecialty of gynecology occupied with treating human infertility, and where the goal of any treatment is the delivery of a healthy newborn. A common ART treatment is In vitro Fertilization (IVF), where embryos are generated in vitro from collected sperm and oocytes, and transferred to the uterus of the patient after selecting those most likely to give rise to a healthy pregnancy. IVF has an approximate 30% successes rate per cycle; to palliate for this low success rate, a common practice so far has been to transfer two embryos simultaneously, aiming to increase the chances of a favorable outcome. While increasing overall live birth rates, this method has also led to an alarmingly high rate of twin and triplet births, associated with four times higher risk of perinatal mortality and increased obstetric complications. Our objective is to predict the chances of both pregnancy (P) and multiple pregnancy (MP) following either single embryo transfer (SET) or double embryo transfer (DET), and in so facilitating an informed decision on how many embryos to transfer. From existing literature, it is known that: (1) it is not possible for the chances of both P and MP to be decreased by increasing the number of embryos; (2) MP chances cannot be higher than P; and (3) chances of pregnancy are highly correlated with age, embryo stage, and quality. With a dataset generated from an existing observational study, we trained several state-of-the-art classifiers to predict P and MP given SET and DET. Analyzing the results, all classifiers achieved promising AUC scores. However, Random Forest and Gradient Boosting predicted negative chance differences in many instances when increasing the number of embryos infringing the first constraint. Logistic Regression predicted always positive differences, but in some instances it infringes the second constraint, predicting higher chances of MP than of P. Moreover, it showed little to no variation across ages or embryo stages violating third constraint. Conventional Machine Learning models struggle to reflect the real-world outcomes when using DET versus SET in specific patients. More informative variables could help, but it is already worrisome that variables as important as age and embryo stage do not result already in any variation, and that when models do show variation, in many cases they predicted decreasing chances of success with more embryos. We conclude that new and different approaches are needed to correctly model this scenario and, likely, many others resembling this one.
Conference papers on the topic "Pregnancy outcome predictors"
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Murarasu, Anne, Gaëlle Guettrot-Imbert, Véronique Le Guern, Francois Maurier, Patrick Jego, Estibaliz Lazaro, Alban Deroux, et al. "P79 Predictors of adverse neonatal outcome during the pregnancy of women with antiphospholipid syndrome in the French GR2 prospective study." In 12th European Lupus Meeting. Lupus Foundation of America, 2020. http://dx.doi.org/10.1136/lupus-2020-eurolupus.124.
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Briggs, Brandi N., Meghan Donnelly, and Virginia L. Ferguson. "Cervical Assessment via Ultrasound Elastography: Calibrated Reference Material Development." In ASME 2013 Summer Bioengineering Conference. American Society of Mechanical Engineers, 2013. http://dx.doi.org/10.1115/sbc2013-14819.
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The human cervix serves a dual structural function throughout pregnancy. Prior to term, the cervix remains closed and firm to support the increasing weight of the fetus. At term, it must soften ( i.e., ripen) and dilate to permit birth. Timing of cervical ripening is critical for pregnancy outcome. Cervical insufficiency, or preterm ripening, is diagnosed if a cervix is not stiff enough to support the pregnancy to term and may cause miscarriage or preterm labor. This is sometimes observed mid-pregnancy when funneling at the internal os or shortening of the cervix is observed during a routine ultrasound. Women with a shorter cervix are at a higher risk for spontaneous preterm delivery. 1,2 While cervical length is not a definitive predictor of preterm delivery, a short cervix increases the risk. Moreover, the exact length at which the cervix is considered to be ‘short’ is poorly defined. While transvaginal B-mode ultrasound can identify a short cervix, this procedure is performed when clinically indicated. Cervical ripening and effacement is asymptomatic and thus is often missed until after a patient has suffered a second or third trimester miscarriage.
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zhan, zhongping, Dongying Chen, Shiwen Yuan, Xiaodong Wang, and Yanfeng Zhan. "THU0285 UMBILICAL ARTERIAL DOPPLER ULTRASONOGRAPHY PREDICTS LATE PREGNANCY OUTCOMES IN PATIENTS WITH LUPUS NEPHRITIS: A MULTICENTER STUDY FROM SOUTHERN CHINA." In Annual European Congress of Rheumatology, EULAR 2019, Madrid, 12–15 June 2019. BMJ Publishing Group Ltd and European League Against Rheumatism, 2019. http://dx.doi.org/10.1136/annrheumdis-2019-eular.1670.
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Longo, Gabrielle, Frida de Luna, and Mahnoor Ahmad. "Health warnings on cannabis dispensary websites." In 2021 Virtual Scientific Meeting of the Research Society on Marijuana. Research Society on Marijuana, 2022. http://dx.doi.org/10.26828/cannabis.2022.01.000.22.
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Cannabis users are increasingly turning towards the Internet for information about cannabis, especially medicinal patients, who generally have low to moderate knowledge of important aspects of cannabis like medicinal effectiveness. Potential for misuse of cannabis is much higher when there is a lack of accurate information (Kruger et al., 2020). Overuse of cannabis can be associated with discontinued enrollment in school, trouble dealing with anxiety and stress, and an increased risk of schizotypy (Blavos et al., 2017). Cannabinoid exposure during pregnancy has been shown to have negative effects on the fetal immune system (Dong et al., 2019), is associated with low birth weight, stunted development (Gusstafson & Jacobsson, 2019), and cognitive impairment (Grant et al., 2018). Cannabis dispensary employees have been found to make health suggestions without proper qualifications (Dickson 2018), and advertising on dispensary websites often suggests strains for specific medical conditions, despite the lack of empirical evidence supporting these claims (Kruger et al., 2020; Luc 2020). This increasing medicalization of cannabis by those unqualified to do so is concerning in such a fast-growing field. The present study assesses the presence of health warnings on cannabis dispensary websites, specifically (a) the presence of facts or warnings about potential psychological consequences (e.g., paranoia, increased vulnerability to psychosis), (b) facts or warnings about use in pregnant women, and (c) general dosage warnings. Dispensaries were selected at random in all states that have legal cannabis. 15 dispensaries were selected from each state. If the state had less than 15, all dispensaries in the state were included in coding, for a total of 389 dispensary websites. Dispensaries were identified via informal cannabis websites like leafly.com and potguides.com, as the purpose of the study was to identify dispensary websites that the average person would find when searching the Internet. Previous studies have utilized state agency lists and informal lists (Cavazos-Rehg et al., 2019). Three trained research assistants coded each website for the relevant information. 30% of websites coded had psychological consequence warnings (n = 111), 21.53% had gynecological health warnings, and 45.65% had general use warnings. Three separate logistic regression analyses were performed with the three types of health warnings as the binary outcome variable (the information is either present = 1, or not present = 0) and legality status as the predictor. Legality status had no impact on the presence of psychological consequence information (OR = .737, SE = .174, p = .196) or general dosage information (OR = .786, SE = .479, p = .279), but legality did have a significant influence on the presence of gynecological consequences (OR = .499, SE = .129, p = .007), indicating that when cannabis was recreationally legal, the state was less likely to have information about gynecological health consequences on their dispensary websites. This is troubling, because cannabis is much more easily accessible in states with recreational legalization than medicinal, and the consequences of cannabis use during pregnancy can be severe.