Fecal Calprotectin: A Biomarker and Predictor of Disease Activity During Pregnancy in Women with IBD
Bibliographic record
Abstract
Introduction: Active inflammatory bowel disease (IBD) during pregnancy is associated with adverse maternal and fetal outcomes, and therefore requires early optimization of therapy. Women with inflammatory bowel disease (IBD) often have gastrointestinal symptoms during pregnancy, but it is often difficult to differentiate between pregnancy symptoms and active IBD. Fecal calprotectin (FCP) is a noninvasive biomarker of intestinal inflammation used to guide the management of IBD. Whether FCP can be used as a biomarker to identify active disease in pregnant women with IBD who have symptoms is not well understood. The objectives of this study were to determine if FCP is elevated during pregnancy in women with IBD who 1) have active disease or 2) who flare within 3 months of the FCP measurment. Methods: Women with IBD (18 to 45 yrs) were followed pre-conception (PC) and at each trimester of pregnancy (T[n]) in the Preconception and Pregnancy in IBD clinic. Women completed the modified Harvey Bradshaw Index (mHBI) for Crohn's disease and the partial Mayo (pMayo) for ulcerative colitis. Women with mHBI > 5 or pMayo > 2 were identified as having clinically active disease. FCP was determined from the first morning stool sample from each visit using the Quantum Blue High Range Reader. We compared the FCP of the women who 1) had active disease vs inactive disease at each study visit, and 2) who flared within 3 months vs who do not flare within 3 months of the FCP measurement. Results: Of the 60 patients enrolled in the clinic, 9 women with Crohn's disease, and 13 women with ulcerative colitis provided stool samples over 27 visits. FCP was elevated in women with active disease compared to women with inactive disease at each clinic visit (Figure 1). FCP was also elevated in women who flared within 3 months (Figure 2). These findings were mainly seen among women with UC.Figure 1Figure 2Conclusion: Fecal calprotectin is elevated before and during pregnancy in women with active IBD, and in women who will flare within 3 months of FCP measurement. FCP has a potential to be used as a noninvasive biomarker of disease activity during pregnancy in women with IBD - in order to confirm disease activity or to identify those at risk of flaring, so that clincians can optimize the management of IBD preconception and during pregnancy, and thus improve maternal and fetal outcomes.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.003 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".