O-238 Preterm birth after recurrent pregnancy loss: A systematic review and meta-analysis
Notice bibliographique
Résumé
Abstract Study question What is the impact of recurrent pregnancy loss on the risk of preterm birth? Summary answer Women with RPL were found to be at increased odds of having preterm deliveries (<37 weeks gestation) in their subsequent live pregnancies. What is known already Recurrent pregnancy loss (RPL) occurs in up to 5% of all women with miscarriages. The emotional, physical, and financial burden associated with RPL is unequivocal, and over the years, much research has gone into the management of RPL. However, relatively little is known about the perinatal outcomes following RPL. Past research in the area reports conflicting data on the association between RPL and preterm birth (PTB) in a subsequent pregnancy. Study design, size, duration A systematic search was performed across thePubMed, EMBASE and Google Scholar databases for relevant studies published up until October 2020. Observational cohort and case-control studies comparing the risk of preterm birth (PTB) among women with and without a history of RPL were included. Effect estimates were pooled using a DerSimonian and Laird random-effects meta-analysis model. Study appraisal was performed using the Newcastle-Ottawa scale. Participants/materials, setting, methods We included studies where the study population consisted of women with a history of RPL (defined as 2 or more pregnancy losses), where the comparator group consisted of women without a history of RPL, and where the outcomes assessed included PTB (defined as birth prior to 37 completed weeks gestation). Two reviewers independently extracted data in duplicate. Publication date, population, exposure and outcome data were extracted. Main results and the role of chance A total of 12 retrospective observational studies met inclusion criteria, and were included in the systematic review and meta-analysis (N = 37,046 women with a history of RPL). Incidence of PTB among the RPL groups ranged from 5.8% to 19.6%, and from 1.5-14.0% in the non-RPL groups. A pooled OR of 1.59 with 95% CI 1.40-1.80 was observed in our random-effects meta-analysis with an I2 of 84%. Subgroup analyses were completed for the pooled risk of only 2 RPL (pooled odds ratio [OR] 1.35; 95% CI 1.08-1.69; I2=84.7%); ≥2 RPL (pooled OR 1.42; 95% CI 0.91-2.22; I2=68.9%); and ≥3 RPL (pooled OR 1.86; 95% CI 1.51-2.29; I2=79.5%). Limitations, reasons for caution Inconsistent adjustment for confounders and significant between-study heterogeneity were noted in this study. Wider implications of the findings Despite significant heterogeneity among studies, we found that women with a history of RPL had significantly higher odds of delivering preterm infants in their subsequent pregnancies. Trial registration number CRD 224763
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 | 0,010 | 0,032 |
| Méta-épidémiologie (sens strict) | 0,002 | 0,001 |
| Méta-épidémiologie (sens large) | 0,017 | 0,038 |
| Bibliométrie | 0,006 | 0,006 |
| Études des sciences et des technologies | 0,001 | 0,001 |
| Communication savante | 0,004 | 0,002 |
| Science ouverte | 0,002 | 0,002 |
| Intégrité de la recherche | 0,002 | 0,002 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,010 | 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 ».