A238 FECAL CALPROTECTIN AND CLINICAL ASSESSMENT TOOLS MAY CORRELATE WITH POOR PREGNANCY-RELATED OUTCOMES IN PATIENTS WITH INFLAMMATORY BOWEL DISEASE
Bibliographic record
Abstract
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
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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 | 0.004 |
| 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 | 0.001 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.002 | 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".