O7 High incidence of both spontaneous and indicated preterm birth in women with systemic lupus erythematosus: a systematic review and meta-analysis
Bibliographic record
Abstract
Objective Preterm birth (PTB) is a frequent complication of pregnancy in women with systemic lupus erythematosus (SLE). The high indicated PTB rate due to hypertensive disorders of pregnancy and/or fetal growth restriction in women with SLE is well known. Preventive measures are taken and screening for early detection are performed, but the risk of spontaneous PTB is less well recognized. The objective of this study is to determine the rates of both spontaneous and indicated PTB in pregnancies of women with SLE. Methods A systematic literature search using Pubmed, Embase, Web of Science and Google Scholar was performed in June 2021. Studies on pregnant women with SLE reporting spontaneous and indicated PTB (birth <37 weeks) rates were selected. Original research articles in English published from 1995 to June 2021 were included. Quality and risk of bias of the included studies were assessed using the Newcastle-Ottawa Quality Assessment Scale (NOS). To estimate the pooled event rates and 95% confidence intervals, meta-analyses of single proportions with a random-effects model were performed. Results We included 21 articles, containing data of 8157 ongoing pregnancies in women with SLE. Fifteen out of the 21 included studies were of good quality according to the NOS. From the ongoing pregnancies, 31% (95% CI [0.26; 0.35]) resulted in PTB, of which 46% (95% CI [0.39; 0.54]) were spontaneous, and 53% (95% CI [0.44; 0.61]) were indicated; in 1% the cause of PTB was unknown. The incidence of spontaneous PTB in all pregnancies was 14% (95% CI [0.11; 0.16]) and of indicated PTB 16% (95% CI [0.12; 0.19]). Conclusion In pregnant women with SLE, spontaneous as well as indicated PTB rates are high. This information should be applied in (pre-pregnancy) counselling and management in pregnancy. The knowledge obtained by this review and meta-analysis paves the way for further research of associated risk factors and development of interventions to reduce spontaneous PTB rate in SLE pregnancies. Funding 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 | 0.012 | 0.032 |
| Meta-epidemiology (narrow) | 0.002 | 0.001 |
| Meta-epidemiology (broad) | 0.014 | 0.031 |
| Bibliometrics | 0.007 | 0.007 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.003 | 0.002 |
| Open science | 0.002 | 0.002 |
| Research integrity | 0.002 | 0.001 |
| Insufficient payload (model declined to judge) | 0.006 | 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".