A149: Does Prenatal Exposure to Antimalarial Decrease the Risk of Neonatal Lupus: a Bayesian Perspective
Notice bibliographique
Résumé
Background/Purpose: It had been suggested that prenatal exposure to hydroxychloroquine reduced the risk of cardiac NLE. The primary aim was to assess if prenatal exposure to antimalarials (AM) decreased the risk of cardiac NLE. The secondary aim was to analyze the effect of AM exposure on the risk of non‐cardiac NLE. Methods: A retrospective cohort study was performed on a large single‐center cohort of children exposed to anti‐Ro and/or anti‐La antibodies on whom prospective data has been collected since 1984. Inclusion criteria were: 1) first child born from a woman positive for anti‐Ro and/or anti‐La antibodies with a diagnosis of cutaneous lupus, systemic lupus erythematosus, Sjogren's syndrome, dermatomyositis or rheumatoid arthritis, 2) the mother underwent fetal chocardiography screening during pregnancy and/or the child had a postnatal ECG and 3) the child was ≥6 months old as of October 2013. We used Bayesian analysis for the association between prenatal use of AM and NLE. Results: The study population consisted of 265 children, of whom 72 were exposed to AM throughout gestation. Full laboratory data was available on 216 infants: 101 (46.8%) developed NLE and 115 (53.2%) remained unaffected. Forty nine children were classified as having no cardiac NLE but could not be diagnosed as true unaffected children as one or more blood test components were missing. These children were only included when the outcome studied was cardiac NLE. On univariable analysis and under a non‐informative prior, the probability that prenatal AM exposure would be protective (RR < 1) was 97.1% for cardiac and 66.9% for non‐cardiac NLE. On multivariable analysis, the RRs obtained were numerically higher, but still suggestive of a protective effect (). Using a more stringent RR cutoff (RR < 0.75), the effect on the outcome cardiac NLE remained significant, unlike for non‐cardiac NLE for which probabilities dropped significantly. Bayesian Analyses of the Effect of Prenatal Exposure to Antimalarial on the Risk of NLE Outcome Prior Sample size (N) RR (95% CrI) Probability of RR <1 (%) Probability of RR <0.75 (%) Univariable analyses Cardiac NLE Non‐informative 265 0.17 (0.01, 1.05) 97.1 93.8 Cardiac NLE Informative 265 0.34 (0.17, 0.66) 99.9 98.9 Non‐cardiac NLE Non‐informative 214 0.93 (0.64, 1.29) 66.9 12.7 Multivariable analyses Cardiac NLE Non‐informative 230 0.31 (0.01, 1.91) 87.8 80.0 Cardiac NLE Informative 230 0.36 (0.18, 0.72) 99.8 98.1 Non‐cardiac NLE Non‐informative 190 0.94 (0.65, 1.31) 64.0 11.6 Independent variable: prenatal exposure to AM Independent variables: prenatal exposure to AM, anti‐Ro ≥50 U/mL, anti‐La ≥50 U/mL and maternal diagnosis (Sjogren's syndrome vs all other diagnosis) NLE: neonatal lupus; RR (95% CrI): relative risk (95% credible interval) Conclusion: In this study of the largest single‐center cohort of children born to anti‐Ro and/or anti‐La antibody positive women with a connective tissue disease, we have shown that the probability that AM exposure was associated with a decreased risk of cardiac NLE was >87%. A clinically significant beneficial effect from AM exposure on non‐cardiac NLE features was not present. These findings need to be confirmed in an independent cohort.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,018 | 0,094 |
| Méta-épidémiologie (sens strict) | 0,001 | 0,001 |
| Méta-épidémiologie (sens large) | 0,002 | 0,003 |
| Bibliométrie | 0,002 | 0,001 |
| Études des sciences et des technologies | 0,001 | 0,002 |
| Communication savante | 0,002 | 0,002 |
| Science ouverte | 0,002 | 0,001 |
| Intégrité de la recherche | 0,003 | 0,002 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,008 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».