scholarly journals Prediction of Preterm Birth by Maternal Characteristics and Medical History in the Brazilian Population

2019 ◽  
Vol 2019 ◽  
pp. 1-6
Author(s):  
Enio Luis Damaso ◽  
Daniel Lober Rolnik ◽  
Ricardo de Carvalho Cavalli ◽  
Silvana Maria Quintana ◽  
Geraldo Duarte ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Preterm Birth ◽  
Medical History ◽  
Roc Curve ◽  
False Positive ◽  
First Trimester ◽  
Multivariate Logistic Regression ◽  
Detection Rates ◽  
Maternal Characteristics ◽  
History Of

Objectives. The aim of this study was to assess the performance of a previously published algorithm for first-trimester prediction of spontaneous preterm birth (PTB) in a cohort of Brazilian women. Methods. This was a retrospective cohort study of women undergoing routine antenatal care. Maternal characteristics and medical history were obtained. The data were inserted in the Fetal Medicine Foundation (FMF) online calculator to estimate the individual risk of PTB. Univariate and multivariate logistic regression analyses were performed to determine the effects of maternal characteristics on the occurrence of PTB. A receiver-operating characteristics (ROC) curve was used to determine the detection rates and false-positive rates of the FMF algorithm in predicting PTB <34 weeks of gestation in our population. Results. In total, 1,323 women were included. Of those, 23 (1.7%) had a spontaneous PTB before 34 weeks of gestation, 87 (6.6%) had a preterm birth between 34 and 37 weeks, and 1,197 (91.7%) had a term delivery. Smoking and a previous history of recurrent PTB between 16 and 30 weeks of gestation without prior term pregnancy were significantly more common among women who delivered before 34 weeks of gestation compared to those who delivered at term were (39.1% vs. 12.0%, p=0.001 and 8.7% vs. 0%, p<0.001, respectively). Smoking and history of spontaneous PTB remained significantly associated with spontaneous PTB in the multivariate logistic regression analysis. Significant prediction of PTB <34 weeks of gestation was provided by the FMF algorithm (area under the ROC curve 0.67, 95% CI 0.56–0.78, p=0.005), but the detection rates for fixed false-positive rates of 10% and 20% were poor (26.1% and 34.8%, respectively). Conclusions. Maternal characteristics and history in the first trimester can significantly predict the occurrence of spontaneous delivery before 34 weeks of gestation. Although the predictive algorithm performed similarly to previously published data, the detection rates are poor and research on new biomarkers to improve its performance is needed.

scholarly journals First-Trimester Screening for Gestational Diabetes Mellitus in Twin Pregnancies

2021 ◽  
Vol 10 (17) ◽  
pp. 3814
Author(s):  
Olga Buerger ◽  
Tania Elger ◽  
Antonia Varthaliti ◽  
Argyro Syngelaki ◽  
Alan Wright ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
False Positive ◽  
False Positive Rate ◽  
First Trimester ◽  
Degree Relative ◽  
Detection Rates ◽  
Previous Pregnancy ◽  
Maternal Characteristics ◽  
Twin Pregnancies ◽  
Singleton Pregnancies

We previously reported a logistic regression model for prediction of GDM from maternal characteristics and medical history in 75,161 singleton pregnancies. In this study of 1376 twin and 13,760 singleton pregnancies recruited at 11–13 weeks’ gestation, we extend the model to include terms for twin pregnancies. We found the respective odds of GDM in dichorionic and monochorionic twin pregnancies to be 1.36 (95% CI: 1.02–1.81) and 2.78 (95% CI: 1.72–4.48) times higher than in singleton pregnancies. In both singleton and twin pregnancies, the risk for GDM increased with maternal age and weight and birth weight z-score of a baby in a previous pregnancy and is higher in women with a previous pregnancy complicated by GDM; in those with a first- or second-degree relative with diabetes mellitus; in women of Black, East Asian, and South Asian racial origin; and in pregnancies conceived through the use of ovulation-induction drugs. In singleton pregnancies, at 10% and 20% false-positive rate, the detection rate was 43% and 58%, respectively. In twin pregnancies, using risk cut-offs corresponding to 10% and 20% false-positive rates in singletons, the respective false-positive rates were 27% and 47%, and the detection rates were 63% and 81%.

Abstract WMP28: Follow-up of Large Intracranial Aneurysms Indicates Growth Frequency Varies According to Location and Size

Stroke ◽  
2013 ◽  
Vol 44 (suppl_1) ◽  
Author(s):  
Aichi Chien ◽  
Feng Liang ◽  
Noriko Salamon ◽  
Pablo Villablanca ◽  
Fernando Vinuela
Keyword(s):  
Logistic Regression ◽  
Medical History ◽  
Multivariate Logistic Regression ◽  
Initial Size ◽  
Univariate Logistic Regression Analysis ◽  
Unruptured Aneurysms ◽  
Factors Associated ◽  
History Of ◽  
Aneurysm Growth

Background: Although treatment is recommended for unruptured large aneurysms (≥7mm), which have higher rupture risk, in practice some aneurysms remain under observation due to a patient’s medical history or age. Detailed data about aneurysm growth during follow-up is limited. In this study, we aim to investigate growth in large aneurysms by reviewing the unruptured aneurysms cases which were followed in our center. Hypothesis: The growth of large unruptured aneurysms varies according to aneurysm characteristics and patient medical history. Method: A retrospective review of patient records based on unruptured aneurysms diagnosed in our center from 2005 to 2011 was performed. Large unruptured aneurysms which had more than one CTA examination separated by at least 3 months were included. Aneurysm characteristics, patient information, and medical history were recorded. Univariate and multivariate logistic regression were used to analyze aneurysm growth. Results: From a total of 410 unruptured aneurysms followed in our center, 50 large aneurysms (41 females, 9 males; age 67.3±12.6 years) were included: 42 aneurysms with initial size 7-12.9 mm, 7 aneurysms 13-23.9 mm, and 1 aneurysm ≥24 mm. During the average 25.6 month follow-up, 15 (30%) aneurysms enlarged and 35 (70%) were unchanged. The growth frequency of aneurysms located in ICA, MCA, ACA, BA was 40%, 22%, 20% and 17%, respectively. The growth frequency of aneurysms of sizes 7-12.9 mm, 13-23.9 mm and ≥24 mm was 23.8%, 71.4% and 0, respectively. Using univariate logistic regression analysis, duration of follow-up (P=0.023), and history of ischemic stroke (P=0.027) were associated with growth. Multivariate logistic regression showed only duration of follow-up as a risk factor for growth (OR, 1.056 per month; 95% CI 1010 to 1.104; P=0.016). Only one aneurysm (ICA) ruptured in the follow-up (70 months), resulting in a rupture rate of 6.7% (1/15) enlarged aneurysms (0/35 unchanged aneurysms). Conclusion: A large percentage of aneurysms selected for observation grew, and growth frequency varied according to aneurysm location and size. A larger, future study may identify additional factors associated with growth, including ones specific to aneurysm characteristics like location and initial size.

Predicting Fetal Chromosome Anomalies in the First Trimester Using Pregnancy Associated Plasma Protein-A: A Comparison of Statistical Methods

1993 ◽  
Vol 32 (02) ◽  
pp. 175-179 ◽  
Author(s):  
B. Brambati ◽  
T. Chard ◽  
J. G. Grudzinskas ◽  
M. C. M. Macintosh
Keyword(s):  
Logistic Regression ◽  
General Population ◽  
Likelihood Ratio ◽  
False Positive ◽  
False Positive Rate ◽  
Ratio Method ◽  
Detection Rates ◽  
Gaussian Distributions ◽  
Positive Rate ◽  
Likelihood Ratio Method

Abstract:The analysis of the clinical efficiency of a biochemical parameter in the prediction of chromosome anomalies is described, using a database of 475 cases including 30 abnormalities. A comparison was made of two different approaches to the statistical analysis: the use of Gaussian frequency distributions and likelihood ratios, and logistic regression. Both methods computed that for a 5% false-positive rate approximately 60% of anomalies are detected on the basis of maternal age and serum PAPP-A. The logistic regression analysis is appropriate where the outcome variable (chromosome anomaly) is binary and the detection rates refer to the original data only. The likelihood ratio method is used to predict the outcome in the general population. The latter method depends on the data or some transformation of the data fitting a known frequency distribution (Gaussian in this case). The precision of the predicted detection rates is limited by the small sample of abnormals (30 cases). Varying the means and standard deviations (to the limits of their 95% confidence intervals) of the fitted log Gaussian distributions resulted in a detection rate varying between 42% and 79% for a 5% false-positive rate. Thus, although the likelihood ratio method is potentially the better method in determining the usefulness of a test in the general population, larger numbers of abnormal cases are required to stabilise the means and standard deviations of the fitted log Gaussian distributions.

High Risk of One-year Stroke Recurrence in Patients with Younger Age and Prior History of Ischemic Stroke

2019 ◽  
Vol 16 (3) ◽  
pp. 250-257 ◽  
Author(s):  
Jiann-Der Lee ◽  
Ya-Han Hu ◽  
Meng Lee ◽  
Yen-Chu Huang ◽  
Ya-Wen Kuo ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Ischemic Stroke ◽  
Multivariate Logistic Regression Analysis ◽  
Stroke Recurrence ◽  
Prior History ◽  
Multivariate Logistic Regression ◽  
Cart Analysis ◽  
Younger Age ◽  
History Of ◽  
One Year

Background and Purpose: Recurrent ischemic strokes increase the risk of disability and mortality. The role of conventional risk factors in recurrent strokes may change due to increased awareness of prevention strategies. The aim of this study was to explore the potential risk factors besides conventional ones which may help to affect the advances in future preventive concepts associated with one-year stroke recurrence (OSR). Methods: We analyzed 6,632 adult patients with ischemic stroke. Differences in clinical characteristics between patients with and without OSR were analyzed using multivariate logistic regression and classification and regression tree (CART) analyses. Results: Among the study population, 525 patients (7.9%) had OSR. Multivariate logistic regression analysis revealed that male sex (OR 1.243, 95% CI 1.025 – 1.506), age (OR 1.015, 95% CI 1.007 - 1.023), and a prior history of ischemic stroke (OR 1.331, 95% CI 1.096 – 1.615) were major factors associated with OSR. CART analysis further identified age and a prior history of ischemic stroke were important factors for OSR when classified the patients into three subgroups (with risks of OSR of 8.8%, 3.8%, and 12.5% for patients aged > 57.5 years, ≤ 57.5 years/with no prior history of ischemic stroke, and ≤ 57.5 years/with a prior history of ischemic stroke, respectively). Conclusions: Male sex, age, and a prior history of ischemic stroke could increase the risk of OSR by multivariate logistic regression analysis, and CART analysis further demonstrated that patients with a younger age (≤ 57.5 years) and a prior history of ischemic stroke had the highest risk of OSR.

Modified Multiple Marker Aneuploidy Screening as a Primary Screening Test for Preeclampsia

2021 ◽  
Author(s):  
Tianhua Huang ◽  
H. Melanie Bedford ◽  
Shamim Rashid ◽  
Evasha Rasasakaram ◽  
Megan Priston ◽  
...  
Keyword(s):  
Preterm Birth ◽  
Early Onset ◽  
Biochemical Markers ◽  
Gestational Hypertension ◽  
First Trimester ◽  
Second Trimester ◽  
Aneuploidy Screening ◽  
Maternal Characteristics ◽  
Screening Performance ◽  
Β Hcg

Abstract Background: Maternal biochemical markers used in multiple marker aneuploidy screening have been associated with adverse pregnancy outcomes. This study aims to assess if a combination of maternal characteristics and biochemical markers in the first and second trimesters can be used to screen for preeclampsia (PE), gestational hypertension and preterm birth. Methods: This case-control study used information on maternal characteristics and residual blood samples from pregnant women who have undergone multiple marker aneuploidy screening. The median multiple of the median (MoM) of first and second trimester biochemical markers in cases (women with PE, gestational hypertension and preterm birth) and controls were compared. Biochemical markers included pregnancy-associated plasma protein A (PAPP-A), placental growth factor (PlGF), human chorionic gonadotropin (hCG), alpha feto-protein (AFP), unconjugated estriol (uE3) and Inhibin A. Logistic regression analysis was used to estimate screening performance using different marker combinations. Screening performance was defined as detection rate (DR) and false positive rate (FPR). Preterm and early-onset preeclampsia PE were defined as women with PE delivered < 37 and < 34 weeks of gestation.Results: There were 147 pregnancies with PE (81 term, 49 preterm and 17 early-onset), 295 with gestational hypertension, and 166 preterm birth. Compared to controls, PE cases had significantly lower median MoM of PAPP-A (0.77 vs 1.10, p<0.0001), PlGF (0.76 vs 1.01, p<0.0001) and free-β hCG (0.81 vs. 0.98, p<0.001) in the first trimester along with PAPP-A (0.82 vs 0.99, p<0.01) and PlGF (0.75 vs 1.02, p<0.0001) in the second trimester. The lowest first trimester PAPP-A, PlGF and free β-hCG were seen in those with preterm and early-onset PE. At a 20% FPR, 67% of preterm and 76% of early-onset PE cases can be predicted using a combination of maternal characteristics with PAPP-A and PlGF in the first trimester.Conclusions: Maternal characteristics with first trimester PAPP-A and PlGF measured for aneuploidy screening provided reasonable accuracy in identifying women at risk of developing early onset PE, allowing triage of high-risk women for further investigation and risk-reducing therapy.

Impact of Including or Removing Nuchal Translucency Measurement on the Detection and False-Positive Rates of First-Trimester Down Syndrome Screening

2015 ◽  
Vol 40 (3) ◽  
pp. 214-218 ◽  
Author(s):  
Emmanuel Spaggiari ◽  
Isabelle Czerkiewicz ◽  
Corinne Sault ◽  
Sophie Dreux ◽  
Armelle Galland ◽  
...  
Keyword(s):  
Down Syndrome ◽  
False Positive ◽  
False Positive Rate ◽  
Method Comparison ◽  
First Trimester ◽  
Nuchal Translucency ◽  
Routine Practice ◽  
Detection Rates ◽  
Significant Difference ◽  
Positive Rate

Introduction: First-trimester Down syndrome (DS) screening combining maternal age, serum markers (pregnancy-associated plasma protein-A and beta-human chorionic gonadotropin) and nuchal translucency (NT) gives an 85% detection rate for a 5% false-positive rate. These results largely depend on quality assessment of biochemical markers and of NT. In routine practice, despite an ultrasound quality control organization, NT images can be considered inadequate. The aim of the study was to evaluate the consequences for risk calculation when NT measurement is not taken into account. Material and Method: Comparison of detection and false-positive rates of first-trimester DS screening (PerkinElmer, Turku, Finland), with and without NT, based on a retrospective study of 117,126 patients including 274 trisomy 21-affected fetuses. NT was measured by more than 3,000 certified sonographers. Results: There was no significant difference in detection rates between the two strategies including or excluding NT measurement (86.7 vs. 81.8%). However, there was a significant difference in the false-positive rates (2.23 vs. 9.97%, p < 0.001). Discussion: Sonographers should be aware that removing NT from combined first-trimester screening would result in a 5-fold increase in false-positive rate to maintain the expected detection rates. This should be an incentive for maintaining quality in NT measurement.

scholarly journals First Trimester Aneuploidy Screening Program for Preeclampsia Prediction in a Portuguese Obstetric Population

2014 ◽  
Vol 2014 ◽  
pp. 1-7 ◽  
Author(s):  
Cláudia Teixeira ◽  
Eduardo Tejera ◽  
Helena Martins ◽  
António Tomé Pereira ◽  
Altamiro Costa-Pereira ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Late Onset ◽  
Screening Program ◽  
First Trimester ◽  
University Hospital ◽  
Aneuploidy Screening ◽  
Detection Rates ◽  
Crown Rump Length ◽  
Screening Programs ◽  
Obstetric Population

Objective. To evaluate the performance of a first trimester aneuploidy screening program for preeclampsia (PE) prediction in a Portuguese obstetric population, when performed under routine clinical conditions.Materials and Methods. Retrospective cohort study of 5672 pregnant women who underwent routine first trimester aneuploidy screening in a Portuguese university hospital from January 2009 to June 2013. Logistic regression-based predictive models were developed for prediction of PE based on maternal characteristics, crown-rump length (CRL), nuchal translucency thickness (NT), and maternal serum levels of pregnancy-associated plasma protein-A (PAPP-A) and free beta-subunit of human chorionic gonadotropin (freeβ-hCG).Results. At a false-positive rate of 5/10%, the detection rate for early-onset (EO-PE) and late-onset (LO-PE) PE was 31.4/45.7% and 29.5/35.2%, respectively. Although both forms of PE were associated with decreased PAPP-A, logistic regression analysis revealed significant contributions from maternal factors, freeβ-hCG, CRL, and NT, but not PAPP-A, for prediction of PE.Conclusion. Our findings support that both clinical forms of EO-PE and LO-PE can be predicted using a combination of maternal history and biomarkers assessed at first trimester aneuploidy screening. However, detection rates were modest, suggesting that models need to be improved with additional markers not included in the current aneuploidy screening programs.

scholarly journals First trimester serum analytes, maternal characteristics and ultrasound markers to?predict pregnancies at risk for preterm birth

Placenta ◽  
2013 ◽  
Vol 34 (1) ◽  
pp. 14-19 ◽  
Author(s):  
M.J. Stout ◽  
K.R. Goetzinger ◽  
M.G. Tuuli ◽  
A.G. Cahill ◽  
G.A. Macones ◽  
...  
Keyword(s):  
At Risk ◽  
Preterm Birth ◽  
First Trimester ◽  
Maternal Characteristics

scholarly journals Demographic and behavioral determinants of self-reported history of sexually-transmitted diseases (STDs) among young migrant men who have sex with men (MSM) in Beijing, China

2011 ◽  
Vol 71 (6) ◽  
pp. 699-708
Author(s):  
Yan Song ◽  
Xiaoming Li ◽  
Liying Zhang ◽  
Yingjie Liu ◽  
Shulin Jiang ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Hiv Prevention ◽  
Sexual Partners ◽  
Intervention Programs ◽  
Multivariate Logistic Regression ◽  
Prevention Intervention ◽  
Hiv Prevention Intervention ◽  
Sexually Transmitted ◽  
History Of ◽  
Sex With Men

Background: Sexually-transmitted disease (STD) is a facilitating cofactor that contributes to human immunodeficiency virus (HIV) transmission. Previous studies indicated a high prevalence of STDs among men who have sex with men (MSM) in China. To date, limited data are available for correlates of STD infection among young migrant MSM in China. The current study intends to examine the association between demographic and behavioral factors and STD infection. Methods: Data were collected from a sample of 307 migrant MSM aged 18–29 years in Beijing in 2009. Multivariate logistic regression analysis was employed to examine the factors associated with a history of STDs. Results: Results showed that about 13% of MSM reported a history of STDs. The average number of lifetime sexual partners was 15.0. About 56.7% of MSM did not use a condom at the first sexual encounter. The percentage of MSM who used a condom consistently was 47.4%. Multivariate logistic regression results showed that STD history was positively associated with education, income, the number of lifetime male sexual partners, and negatively associated with the frequency of properly using a condom. Conclusion: STD history was associated with socioeconomic status and sexual risk behaviors. The results suggested that HIV prevention intervention programs need to educate MSM to reduce the number of sexual partners and to use a condom properly. Furthermore, HIV prevention intervention programs among MSM need to be tailored to meet the needs of different socioeconomic groups of MSM.

scholarly journals Title: Preoperative albumin-to-fibrinogen ratio predicts postoperative pulmonary complications in patients after minimally invasive esophagectomy

2021 ◽  
Author(s):  
Zhang Peng ◽  
Zhao Song
Keyword(s):  
Risk Factors ◽  
Esophageal Cancer ◽  
Logistic Regression ◽  
Roc Curve ◽  
Training Group ◽  
Pulmonary Complications ◽  
Curve Analysis ◽  
Postoperative Pulmonary Complications ◽  
Multivariate Logistic Regression ◽  
Roc Curve Analysis

Abstract Background Postoperative pulmonary complications (PPCs) are the most common postoperative complications in patients with esophageal cancer. Prediction of PPCs by establishing a preoperative physiological function parameter model can help patients make adequate preoperative preparation, reduce treatment costs, and improve prognosis and quality of life. The purpose of this study was to investigate the relationship between albumin-to-fibrinogen ratio (AFR), prognostic nutritional index (PNI), albumin-to-globulin ratio (AGR), neutrophils-to-lymphocyte ratio (NLR), platelet-to-lymphocyte (PLR), and monocyte-to -lymphocyte ratio (MLR) and other preoperative laboratory tests and PPCs in patients after esophagectomy. Methods Retrospective analysis was performed on total 712 consecutive patients who underwent esophagectomy in the Department of Thoracic Surgery, The First Affiliated Hospital of Zhengzhou University from July 2018 to December 2020. Patients were divided into training (535 patients) and validation (177) groups for comparison of baseline data, perioperative indicators, and laboratory examination data. Receiver operating characteristic (ROC) curve analysis was used to evaluate the efficacy, sensitivity and specificity of AFR, and Youden’s index was used to calculate the cut-off values of AFR. Univariate and multivariate logistic regression analyses were used to assess the risk factors for PPCs in training group. Results 112 (20.9%) in training group and 36 (20.3%) in validation group developed PPCs. The AUC value predicted by AFR using ROC curve analysis was 0.817, sensitivity 76.2% and specificity 78.7% in training group while AUC 0.803, sensitivity 69.4% and specificity 85.8%. Multivariate logistic regression analysis showed that smoking index, American Society of Anesthesiologists (ASA), AFR, and recurrent laryngeal nerve palsy were independent risk factors for PPCs. Conclusion Preoperative AFR can effectively predict the occurrence of PPCs in patients with esophageal cancer

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