A104 PREGNANCY OUTCOMES IN WOMEN WITH INFLAMMATORY BOWEL DISEASE AND EXPOSURE TO BIOLOGICS - A PROSPECTIVE COHORT STUDY
Notice bibliographique
Résumé
Inflammatory bowel disease (IBD) has a peak incidence rate in women of reproductive age. Biologic agents are commonly used in IBD management. However, prospective safety data on biologics exposure in the pregnant population remain limited. To assess baseline differences, and to compare obstetrical and neonatal outcomes in women with IBD who are exposed and non-exposed to biologics during pregnancy. Since November 2014, pregnant women with ulcerative colitis (UC) or Crohn’s disease (CD) were enrolled in a prospective registry. Patients were assessed every trimester, and at three, six, and 12-months post-partum. Disease activity, pregnancy complications, and delivery and newborn outcomes were recorded. Women were divided into exposed (adalimumab [ADA], infliximab [IFX], vedolizumab [VDZ], or ustekinumab [UST]) and non-exposed (no medications or 5-aminosalicylic acid [5-ASA]) groups. Patients taking only immunomodulators were excluded. Mann–Whitney U and Fisher’s exact tests were used to identify differences between groups. To date, 36 patients have been enrolled in the study, totalling 38 pregnancy events. Sixteen pregnancy events were exposed to biologics: 9 (56.2%) ADA, 4 (25.0%) IFX, 2 (12.5%) VDZ, 1 (6.2%) UST. Twenty-two pregnancy events were not exposed: 8 (36.4%) 5-ASAs and 14 (64.6%) no medications. Within the exposed and non-exposed groups, 13 (81.3%) and 14 (63.6%) women had CD, respectively. The exposed group had fewer patients with a smoking history (1 [6.3%] vs 11 [50.0%], p=0.04), while a higher proportion had an annual household income above $100,000 (11 [78.6%] vs 7 [35.0%], p=0.012). No differences were observed between groups for adverse pregnancy diagnoses (gestational hypertension and diabetes, preeclampsia/eclampsia), post-partum infections, and neonatal outcomes (low birth weight, prematurity, and infections). Disease relapse during pregnancy (5 [31.3%] vs 8 [36.4%], p=0.74) and steroid use (4 [25%] vs 3 [13.6%], p=0.42) were similar between exposed and non-exposed groups, respectively. Caesarian section (CS) occurred in 7 (46.7%) of exposed and 10 (62.5%) of non-exposed group (p=0.38), while 6 (16.7%) patients in total had active perianal disease. There was a trend towards significance for increased emergency CS within the non-exposed (6 [37.5%]) compared to exposed group (1 [6.7%], p=0.08). No significant difference was observed for breast feeding rates between groups. Biologics exposure does not appear to be associated with adverse pregnancy and neonatal outcomes. Higher socioeconomic status was linked to women using biologics during pregnancy. A high CS rate was also observed overall while few had an IBD-related indication. Future studies should explore any barriers to accessing biologics in Canada, and the propensity for CS in women with IBD. Saskatchewan Health Research Foundation (SHRF)
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 | 0,001 | 0,003 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,001 |
| Méta-épidémiologie (sens large) | 0,000 | 0,001 |
| Bibliométrie | 0,001 | 0,002 |
| Études des sciences et des technologies | 0,001 | 0,000 |
| Communication savante | 0,001 | 0,001 |
| Science ouverte | 0,000 | 0,001 |
| Intégrité de la recherche | 0,001 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,003 | 0,001 |
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 ».