Natural history of Secundum ASD in preterm and term neonates: A comparative study
Bibliographic record
Abstract
Abstract Background: Atrial septal defects(ASDs) are common in neonates. Although past studies suggest ASDs >3mm in term neonates(TN) are less likely to close, there is paucity of data regarding the natural history in preterm neonates(PN), information that would inform surveillance. We sought to compare spontaneous closure rates and need for intervention for ASDs in TN/near term (>36 weeks) versus PN (<36 weeks). Methods: We included all TN and PN who underwent echocardiography at <1 month between 2010-2018 in our institution with an ASD >3mm, without major congenital heart disease, and with repeat echocardiogram(s). Spontaneous resolution was defined as size diminution to £3mm or closure. Results: We included 156 TN (mean gestational age at birth 38.6±1.4 weeks) and 156 PN (29.6±3.7 weeks) with a mean age at follow-up of 16±19 and 15±21 months, respectively (p=0.76). Based on largest color Doppler diameter, in TNs, ASD resolution occurred in 95% of small (3-5mm), 87% of moderate (5.1-8mm), and 60% of large (>8mm) defects; whereas, in PNs, resolution occurred in 79% of small, 76% of moderate, and 33% of large ASDs. There was a significant association between size and ASD resolution in TNs (p=0.003), but not PNs (p=0.17). Overall, ASD resolution rate was higher in TNs (89%) versus PNs (78%) (p=0.009), and fewer TNs (1%) compared to PNs (7%) required ASD intervention (p=0.02). Conclusion: Most ASDs identified in TN and PN spontaneously resolve. PN, however, demonstrate lower ASD resolution and higher intervention rates within all size groups. These data should inform follow-up of affected neonates.
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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 | 0.006 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.002 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.000 |
| 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".