Healthcare Utilization in Women With and Without Inflammatory Bowel Diseases From Preconception to Postpartum and Their Infants Up To Five Years of Life
Notice bibliographique
Résumé
Women with inflammatory bowel disease (IBD) are at increased risk of adverse pregnancy outcomes compared to those without IBD. Their infants may also be at risk of developing complications in early life due to genetic susceptibilities and in utero exposure to maternal inflammation. Understanding how women with IBD navigate the healthcare system during periods such as pregnancy, and their infants during the first few years of life, offers a unique opportunity to identify risk factors for adverse pregnancy and neonatal outcomes and disparities in access to high-quality ambulatory care. Furthermore, identifying these disparities in vulnerable populations such as new immigrants with IBD may lead to a clearer understanding of major health delivery problems. The availability of large healthcare administrative databases at ICES in Ontario, Canada allowed us the opportunity to achieve these goals. In Aim # 1, we found that compared to those without IBD, women with IBD were significantly more likely to visit the emergency department (ED) and be hospitalized during pregnancy and postpartum, particularly for venous thromboembolic reasons. Women with IBD were also more likely to receive adequate prenatal care. In Aim # 2, we found that recent immigrants (within 5 years of conception) with IBD had increased ambulatory and endoscopy visits during preconception and postpartum but were much less likely to receive adequate prenatal care. Those immigrating from the South Americas were the least likely to receive adequate prenatal care. In Aim # 3, we found that compared to those born to women without IBD, infants born to women with IBD had increased risk of hospitalizations, ED visits, and increased rates of mental health related ambulatory visits such as those for neurodevelopmental concerns in the first 5 years of life. There remains disparity in healthcare use between women with and without IBD from preconception to postpartum, and infants born to these women in the first few years of life. These thesis findings provide critical evidence for Canadian policymakers to further allocate resources towards the development of healthcare programs that aim to provide equitable, timely, and high-quality care to all women living with IBD during pregnancy, and their infants during the first few years of life.
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 | 0,000 | 0,002 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,001 |
| Bibliométrie | 0,001 | 0,001 |
| Études des sciences et des technologies | 0,001 | 0,000 |
| Communication savante | 0,001 | 0,000 |
| Science ouverte | 0,001 | 0,001 |
| Intégrité de la recherche | 0,000 | 0,001 |
| 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 ».