Abstract 4362430: Maternal Socioeconomic Status Impacts Diagnosis and Surveillance of Anti-Ro/SSA Positive Pregnancies Complicated by Fetal Cardiac Neonatal Lupus: A Fetal Heart Society (FHS) Research Collaborative Study
Bibliographic record
Abstract
Introduction: Knowing maternal anti-Ro antibody status prior to pregnancy is important since surveillance can detect early and treatable manifestations of fetal cardiac neonatal lupus (CNL); unfortunately, antibodies are identified after fetal CNL diagnosis in about 50% of cases. Studies have shown that prenatal detection of congenital heart disease falls short in patients of lower socioeconomic status, but effects of social health determinants on timing of anti-Ro diagnosis are unknown. We sought to determine whether neighborhood deprivation was associated with late detection of anti-Ro antibodies. Methods: A retrospective, multicenter, FHS cohort identified fetuses/infants with CNL between January 2013-2024. We compared race, ethnicity, childhood opportunity index (COI, diversitydatakids.org) and proximity to subspecialty care between pregnant persons with prior knowledge of anti-Ro+ and those diagnosed after onset of fetal CNL (atrioventricular block [AVB], cardiomyopathy, valvulitis, hydrops and/or endocardial fibroelastosis). Statistical tests included linear regression, Mann-Whitney, and Fisher’s exact performed in Rv4.2.2. Results: In our cohort of 234 anti-Ro+ pregnancies from 22 centers, 236 fetuses/infants had CNL. Over half (58.6%) were unaware of anti-Ro status at CNL diagnosis. There were no racial or ethnic differences in maternal knowledge of anti-Ro status prior to CNL diagnosis. Neighborhood deprivation (low/very low COI Social/Economic Domain) and public insurance were associated with late detection of anti-Ro antibodies (p=0.024 and p=0.004, respectively). For those with lower COI, distance to maternal-fetal-medicine (MFM, p=0.017) was significantly increased. Gestational age (GA) at CNL diagnosis and proximity to MFM (p=0.002) or cardiology (p=0.027) were significantly associated; for every 10-mile increase in distance to MFM or cardiology, GA at diagnosis increased by 0.14 weeks (95% CI: 0.05-0.23 weeks) or by 0.06 weeks (95% CI: 0.01-0.12 weeks), respectively. Pregnancies with known anti-Ro+ status were diagnosed with CNL 1.5 weeks earlier (p=0.002; 95% CI: 0.6-2.5 weeks). Conclusions: Pregnant persons with public insurance or from lower opportunity neighborhoods were less likely to know their anti-Ro status prior to fetal/infantile CNL diagnosis and at a GA in which rapid treatment could be effective. Universal anti-Ro pregnancy screening could potentially mitigate these disparities.
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
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 | 0.002 | 0.005 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| 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".