SOCIAL DEPRIVATION AND PRE-ECLAMPSIA RECURRENCE: THE NATIONWIDE CONCEPTION STUDY
Notice bibliographique
Résumé
Objective: The recurrence rate of pre-eclampsia in a subsequent pregnancy ranges between 10 and 20% in the literature. We aimed to study the association between social deprivation and the prevention and recurrence of preeclampsia. Design and method: All women of the nationwide Conception study (elaborated from French National Health Insurance Information System) who gave birth for the first time in France in 2010-2018, and who subsequently gave birth in the same period were included. Pre-eclampsia was identified through hospital diagnoses. Aspirin deliveries during the second pregnancy were collected to assess the rate and timing of initiation, and the treatment adherence. All medical consultations in the year before the beginning of their second pregnancy and until 20 weeks of gestation were identified. Women who benefitted from Universal Medical Coverage providing free access to health care for people with an annual income less than 60% of the poverty threshold were defined as living in social deprivation. The adjusted incidence rate ratios (aIRR) of preeclampsia during the second pregnancy were estimated using Poisson models adjusted for confounding Results: Of the 2,829,274 women included, 31,956 (1.9%) were diagnosed with a pre-eclampsia during their first pregnancy. From those, 4,697 (14.7%) had recurrent pre-eclampsia during the second pregnancy. Women living in social deprivation had more cardiovascular risk factors, were less likely to consult a physician in the year before and until 20 weeks of gestation (90.3% vs 97.5%), to receive prescribed aspirin at least once during their second pregnancy (33.7 vs 45.7%), to begin the treatment before 16 week of gestation (81.4 vs 90.7% among those receiving at least one delivery of aspirin during pregnancy), and to be adherent to therapy throughout the pregnancy (44.6 vs 55.9%). In multivariate analyses, women living in social deprivation were less likely to initiate aspirin during the second pregnancy (aIRR = 0.74 [0.70-0.78] and had a higher risk of pre-eclampsia recurrence (aIRR = 1.31 [1.28-1.33]). Conclusions: Greater efforts should be made to improve the medical monitoring and prevention strategies of socially deprived women with pre-eclampsia because of their high risk of recurrence.
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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 | 0,002 |
| 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 | 0,001 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,001 | 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 ».