A238 FECAL CALPROTECTIN AND CLINICAL ASSESSMENT TOOLS MAY CORRELATE WITH POOR PREGNANCY-RELATED OUTCOMES IN PATIENTS WITH INFLAMMATORY BOWEL DISEASE
Notice bibliographique
Résumé
Abstract Background Patients with inflammatory bowel disease (IBD) are at risk of developing adverse pregnancy-related outcomes. Though active disease has been associated with these outcomes, the optimal method of disease assessment in these patients remains unknown. Aims To determine whether clinical and/or objective disease activity correlates with poor maternal and neonatal outcomes in patients with IBD. Methods We retrospectively reviewed the University of Alberta and University of Toronto pregnancy databases to identify patients (age > 18) who underwent routine assessment by a gastroenterologist during any gestational period (first trimester (T1), second trimester (T2), and third trimester (T3). Those with at least one fecal calprotectin (FCP) level during pregnancy were included. Active disease was defined clinically (modified Harvey-Bradshaw Index score ≥ 5 or partial Mayo score ≥ 2) or objectively using stool markeres (FCP ≥ 250 ug/g). Pregnancy-related outcomes (maternal, obstetrical, and neonatal) were recorded from obstetrical records. Low-birth weight (LBW) was defined as an infant weight < 2500g at birth. Continuous variables were reported as medians with interquartile ranges (IQR) and compared with nonparametric Mann-Whitney U and Kruskal-Wallis one-way analysis tests. Categorical variables were compared using the Chi-square (x2) test. Results A total of 85 patients were included. The median FCP in T1 was significantly higher in patients who underwent emergency C-section (503, IQR 1554.3) compared to those who did not (130, IQR 482) (p=0.03). Similarly, the median FCP in T1 was significantly higher in mothers who delivered an infant with LBW (1511, IQR 579) compared to those whose did not (145, IQR 413) (p=0.049). When active disease was defined only by clinical scores, 25% of those with active disease in T1 had a failed vaginal delivery compared to only 2.9% in remission (p=0.027). Similarly, 12.5% of patients with clinically active disease in T1 delivered an infant with congenital anomalies compared to none in clinical remission (p=0.034). When disease activity was defined objectively, those with a FCP > 250 ug/g in T3 were more likely to have an induced vaginal delivery (43.8%) compared to only 14.3% in those in remission (p=0.03). Finally, when disease activity was defined as a combination of clinical scores and FCP > 250 ug/g, those with active disease in T3 had a trend towards an increased risk of induced vaginal delivery (active: 40.0% vs. remission: 17.0%, p=0.064), chorioamnionitis (active: 6.3% vs. remission: 0%, p=0.081) and congenital anomalies (active: 6.3% vs. remission: 0%, p=0.081). Conclusions IBD assessment during pregnancy likely requires a combination of clinical scores and objective markers in order to identify patients at high-risk of developing poor peripartum outcomes. Funding Agencies None
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 | 0,004 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,001 | 0,001 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,001 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,002 | 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 ».