التفاصيل البيبلوغرافية
| العنوان: |
Development and validation of a risk prediction model of preterm birth for women with preterm labour symptoms (the QUIDS study): A prospective cohort study and individual participant data meta-analysis |
| المؤلفون: |
Stock, Sarah J, Horne, Margaret, Bruijn, Merel, White, Helen, Boyd, Kathleen A, Heggie, Robert, Wotherspoon, Lisa, Aucott, Lorna, Morris, Rachel K, Dorling, Jon, Jackson, Lesley, Chandiramani, Manju, David, Anna L, Khalil, Asma, Shennan, Andrew, van Baaren, Gert-Jan, Hodgetts-Morton, Victoria, Lavender, Tina, Schuit, Ewoud, Harper-Clarke, Susan, Mol, Ben W, Riley, Richard D, Norman, Jane E, Norrie, John |
| المساهمون: |
Epi Methoden Team 1, JC onderzoeksprogramma Methodologie, Epi Methoden Team 4 |
| سنة النشر: |
2021 |
| مصطلحات موضوعية: |
General Medicine |
| الوصف: |
Background Timely interventions in women presenting with preterm labour can substantially improve health outcomes for preterm babies. However, establishing such a diagnosis is very challenging, as signs and symptoms of preterm labour are common and can be nonspecific. We aimed to develop and externally validate a risk prediction model using concentration of vaginal fluid fetal fibronectin (quantitative fFN), in combination with clinical risk factors, for the prediction of spontaneous preterm birth and assessed its cost-effectiveness. Methods and findings Pregnant women included in the analyses were 22+0 to 34+6 weeks gestation with signs and symptoms of preterm labour. The primary outcome was spontaneous preterm birth within 7 days of quantitative fFN test. The risk prediction model was developed and internally validated in an individual participant data (IPD) meta-analysis of 5 European prospective cohort studies (2009 to 2016; 1,783 women; mean age 29.7 years; median BMI 24.8 kg/m2; 67.6% White; 11.7% smokers; 51.8% nulliparous; 10.4% with multiple pregnancy; 139 [7.8%] with spontaneous preterm birth within 7 days). The model was then externally validated in a prospective cohort study in 26 United Kingdom centres (2016 to 2018; 2,924 women; mean age 28.2 years; median BMI 25.4 kg/m2; 88.2% White; 21% smokers; 35.2% nulliparous; 3.5% with multiple pregnancy; 85 [2.9%] with spontaneous preterm birth within 7 days). The developed risk prediction model for spontaneous preterm birth within 7 days included quantitative fFN, current smoking, not White ethnicity, nulliparity, and multiple pregnancy. After internal validation, the optimism adjusted area under the curve was 0.89 (95% CI 0.86 to 0.92), and the optimism adjusted Nagelkerke R2 was 35% (95% CI 33% to 37%). On external validation in the prospective UK cohort population, the area under the curve was 0.89 (95% CI 0.84 to 0.94), and Nagelkerke R2 of 36% (95% CI: 34% to 38%). Recalibration of the model's intercept was required to ensure overall ... |
| نوع الوثيقة: |
article in journal/newspaper |
| وصف الملف: |
application/pdf |
| اللغة: |
English |
| تدمد: |
1549-1277 |
| Relation: |
https://dspace.library.uu.nl/handle/1874/444637 |
| الاتاحة: |
https://dspace.library.uu.nl/handle/1874/444637 |
| Rights: |
info:eu-repo/semantics/OpenAccess |
| رقم الانضمام: |
edsbas.F26FE727 |
| قاعدة البيانات: |
BASE |
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