OBJECTIVE: To explore a conceptual framework of clinical conditions associated with preterm birth (PTB) by cluster analysis, assessing determinants for different PTB subtypes and related maternal and neonatal outcomes. METHODS: Secondary analysis of the Brazilian Multicentre Study on Preterm Birth of 33 740 births in 20 maternity hospitals between April 2011 and July 2012. In accordance with a prototype concept based on maternal, fetal, and placental conditions, an adapted k-means model and fuzzy algorithm were used to identify clusters using predefined conditions. The mains outcomes were phenotype clusters and maternal and neonatal outcomes. RESULTS: Among 4150 PTBs, three clusters of PTB phenotypes were identified: women who had PTB without any predefined conditions; women with mixed conditions; and women who had pre-eclampsia, eclampsia, HELLP syndrome and fetal growth restriction. The prevalence of different preterm subtypes differed significantly in the three clusters, varying from 80.95% of provider-initiated PTBs in cluster 3-6.62% in cluster 1 (P<0.001). Although some maternal characteristics differed among the clusters, maternal and neonatal outcomes did not. CONCLUSIONS: The analysis identified three clusters with distinct phenotypes. Women from the different clusters had different subtypes of PTB and maternal and pregnancy characteristics.
OBJECTIVE: To explore a conceptual framework of clinical conditions associated with preterm birth (PTB) by cluster analysis, assessing determinants for different PTB subtypes and related maternal and neonatal outcomes. METHODS: Secondary analysis of the Brazilian Multicentre Study on Preterm Birth of 33 740 births in 20 maternity hospitals between April 2011 and July 2012. In accordance with a prototype concept based on maternal, fetal, and placental conditions, an adapted k-means model and fuzzy algorithm were used to identify clusters using predefined conditions. The mains outcomes were phenotype clusters and maternal and neonatal outcomes. RESULTS: Among 4150 PTBs, three clusters of PTB phenotypes were identified: women who had PTB without any predefined conditions; women with mixed conditions; and women who had pre-eclampsia, eclampsia, HELLP syndrome and fetal growth restriction. The prevalence of different preterm subtypes differed significantly in the three clusters, varying from 80.95% of provider-initiated PTBs in cluster 3-6.62% in cluster 1 (P<0.001). Although some maternal characteristics differed among the clusters, maternal and neonatal outcomes did not. CONCLUSIONS: The analysis identified three clusters with distinct phenotypes. Women from the different clusters had different subtypes of PTB and maternal and pregnancy characteristics.
Authors: Ferdinand Dhombres; Jules Bonnard; Kévin Bailly; Paul Maurice; Aris T Papageorghiou; Jean-Marie Jouannic Journal: J Med Internet Res Date: 2022-04-20 Impact factor: 7.076
Authors: Ricardo P Tedesco; Rafael B Galvão; Jose Paulo Guida; Renato Passini-Júnior; Giuliane J Lajos; Marcelo L Nomura; Patricia M Rehder; Tabata Z Dias; Renato T Souza; Jose G Cecatti Journal: Clinics (Sao Paulo) Date: 2020-03-23 Impact factor: 2.365