1
|
Hennessy A, Tran TH, Sasikumar SN, Al-Falahi Z. Machine learning, advanced data analysis, and a role in pregnancy care? How can we help improve preeclampsia outcomes? Pregnancy Hypertens 2024; 37:101137. [PMID: 38875933 DOI: 10.1016/j.preghy.2024.101137] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2024] [Revised: 03/31/2024] [Accepted: 06/09/2024] [Indexed: 06/16/2024]
Abstract
The value of machine learning capacity in maternal health, and in particular prediction of preeclampsia will only be realised when there are high quality clinical data provided, representative populations included, different health systems and models of care compared, and a culture of rapid use and application of real-time data and outcomes. This review has been undertaken to provide an overview of the language, and early results of machine learning in a pregnancy and preeclampsia context. Clinicians of all backgrounds are encouraged to learn the language of Machine Learning (ML) and Artificial intelligence (AI) to better understand their potential and utility to improve outcomes for women and their families. This review will outline some definitions and features of ML that will benefit clinician's knowledge in the preeclampsia discipline, and also outline some of the future possibilities for preeclampsia-focussed clinicians via understanding AI. It will further explore the criticality of defining the risk, and outcome being determined.
Collapse
Affiliation(s)
- Annemarie Hennessy
- Campbelltown Hospital, South Western Sydney Local Health District, Sydney, Australia; Western Sydney University, Sydney, Australia; University of Sydney, Sydney, Australia.
| | - Tu Hao Tran
- Campbelltown Hospital, South Western Sydney Local Health District, Sydney, Australia; Ingham Institute for Applied Medical Research, SWERI (South Western Emergency Research Institute), Australia.
| | - Suraj Narayanan Sasikumar
- Ingham Institute for Applied Medical Research, SWERI (South Western Emergency Research Institute), Australia.
| | - Zaidon Al-Falahi
- University of Sydney, Sydney, Australia; Ingham Institute for Applied Medical Research, SWERI (South Western Emergency Research Institute), Australia.
| |
Collapse
|
2
|
Teka H, Yemane A, Abraha HE, Berhe E, Tadesse H, Gebru F, Yahya M, Tadesse Y, Gebre D, Abrha M, Tesfay B, Tekle A, Gebremariam T, Amare B, Ebrahim MM, Zelelow YB, Mulugeta A. Clinical presentation, maternal-fetal, and neonatal outcomes of early-onset versus late onset preeclampsia-eclampsia syndrome in a teaching hospital in a low-resource setting: A retrospective cohort study. PLoS One 2023; 18:e0281952. [PMID: 36848332 PMCID: PMC9970097 DOI: 10.1371/journal.pone.0281952] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2022] [Accepted: 02/04/2023] [Indexed: 03/01/2023] Open
Abstract
BACKGROUND Pre-eclampsia-eclampsia syndrome remains the leading cause of maternal and neonatal mortality worldwide. Both from pathophysiologic and clinical stand points, early and late onset preeclampsia are thought to be two different disease entities. However, the magnitude of preeclampsia-eclampsia and maternal-fetal and neonatal outcomes of early and late onset preeclampsia are not adequately investigated in resource-limited settings. This study sought to examine the clinical presentation and maternal-fetal and neonatal outcome of these two entities of the disease in Ayder comprehensive specialized hospital, an academic setting in Tigray, Ethiopia, from January 1, 2015-December 31, 2021. METHODS A retrospective cohort design was employed. The patient charts were reviewed to see the baseline characteristics and their progress from the onset of the disease in the antepartum, intrapartum and postpartum periods. Women who developed pre-eclampsia before 34 weeks of gestation were defined as having early-onset pre-eclampsia, and those who developed at 34 weeks or later were identified as late-onset preeclampsia. We used chi-square, t-test and multivariable logistic regression analyses to determine differences between early- and late onset diseases in terms of clinical presentation, maternal-fetal, and neonatal outcomes. RESULTS Among the 27,350 mothers who gave birth at the Ayder comprehensive specialized hospital, 1095 mothers had preeclampsia-eclampsia syndrome, with a prevalence of 4.0% (95% CI: 3.8, 4.2)]. Of the 934 mothers analyzed early and late onset diseases accounted for 253 (27.1%) and 681 (72.9%) respectively. Overall, death of 25 mothers was recorded. Women with early onset disease had significant unfavorable maternal outcomes including having preeclampsia with severity features (AOR = 2.92, 95% CI: 1.92, 4.45), liver dysfunction (AOR = 1.75, 95% CI: 1.04, 2.95), uncontrolled diastolic blood pressure (AOR = 1.71, 95% CI: 1.03, 2.84), and prolonged hospitalization (AOR = 4.70, 95% CI: 2.15, 10.28). Similarly, they also had increased unfavorable perinatal outcomes, including the APGAR score at the 5th minute (AOR = 13.79, 95% CI: 1.16, 163.78), low birth weight (AOR = 10.14, 95% CI 4.29, 23.91), and neonatal death (AOR = 6.82, 95% CI: 1.89, 24.58). CONCLUSION The present study highlights the clinical differences between early versus late onset preeclampsia. Women with early-onset disease are at increased levels of unfavorable maternal outcomes. Perinatal morbidity and mortality were also increased significantly in women with early onset disease. Therefore, gestational age at the onset of the disease should be taken as an important indicator of the severity of the disease with unfavorable maternal, fetal, and neonatal outcomes.
Collapse
Affiliation(s)
- Hale Teka
- Department of Obstetrics and Gynecology, School of Medicine, Mekelle University, Mek’ele, Ethiopia
- * E-mail:
| | - Awol Yemane
- Department of Obstetrics and Gynecology, School of Medicine, Mekelle University, Mek’ele, Ethiopia
| | - Hiluf Ebuy Abraha
- Ayder Comprehensive Specialized Hospital, Quality Assurance Office, Mekelle University, Mek’ele, Ethiopia
| | - Ephrem Berhe
- Department of Internal Medicine, School of Medicine, Mekelle University, Mek’ele, Ethiopia
| | - Habtom Tadesse
- Department of Obstetrics and Gynecology, School of Medicine, Mekelle University, Mek’ele, Ethiopia
| | - Fanos Gebru
- Department of Obstetrics and Gynecology, School of Medicine, Mekelle University, Mek’ele, Ethiopia
| | - Mohammedtahir Yahya
- Department of Obstetrics and Gynecology, School of Medicine, Mekelle University, Mek’ele, Ethiopia
| | - Ytbarek Tadesse
- Department of Obstetrics and Gynecology, School of Medicine, Mekelle University, Mek’ele, Ethiopia
| | - Daniel Gebre
- Department of Midwifery, Ayder Comprehensive Specialised Hospital, Mekelle University, Mek’ele, Ethiopia
| | - Marta Abrha
- Department of Internal Medicine, School of Medicine, Mekelle University, Mek’ele, Ethiopia
| | - Bisrat Tesfay
- Department of Internal Medicine, School of Medicine, Mekelle University, Mek’ele, Ethiopia
| | - Ashenafi Tekle
- Department of Obstetrics and Gynecology, School of Medicine, Mekelle University, Mek’ele, Ethiopia
| | - Tsega Gebremariam
- Department of Obstetrics and Gynecology, School of Medicine, Mekelle University, Mek’ele, Ethiopia
| | - Birhane Amare
- Department of Obstetrics and Gynecology, School of Medicine, Mekelle University, Mek’ele, Ethiopia
| | | | - Yibrah Berhe Zelelow
- Department of Obstetrics and Gynecology, School of Medicine, Mekelle University, Mek’ele, Ethiopia
| | - Afework Mulugeta
- Department of Nutrition, School of Public Health, Mekelle University, Mek’ele, Ethiopia
| |
Collapse
|
3
|
Hussein AI, Kurtay S, Omar AA, Yusuf AA, Mohamud RYH. An Analysis of the Rate, Indications, and Associated Maternal Mortality for Cesarean Sections at a Tertiary Care Hospital, First Report from Somalia. Int J Womens Health 2023; 15:225-233. [PMID: 36816454 PMCID: PMC9930581 DOI: 10.2147/ijwh.s383122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2022] [Accepted: 02/01/2023] [Indexed: 02/12/2023] Open
Abstract
Background There has been an increase in worldwide cesarean section rates, although they remain low in most Sub-Saharan African countries, including Somalia. The present is the first hospital-based study that analyzes the rate, indications, and associated maternal mortality of cesarean deliveries reported from Somalia. Methods This retrospective study reviewed data of all deliveries from 2015 to 2021 using electronic medical records in the hospital information system. Retrieved data include baseline demographic characteristics, mode of delivery, indications and the type of cesarean section, and the documented maternal mortality during the study period. Results During seven years, there were 12,540 total deliveries. Among these, 2703 were cesarean sections giving an overall cesarean section rate of 21.6%. The mean age of the patients was 26.7±7.3 years [14-44 years]. Multiparous mothers constituted 67.7% during the study period. According to cesarean deliveries, nulliparous mothers (55.7%) underwent the maximum number of cesarean sections. Emergency cesarean section was the predominant intervention compared to elective C-sections (59.2% vs 40.8%). Primary CS was the most common predominant, while repeat CS increased timely, 77.7% vs 22.3%, respectively. Overall, previous C-sections and fetal distress were the two most common indications for cesarean delivery (22.3% and 22.1%), respectively. C-sections were predominant in women of younger age, Primiparity, having term deliveries, and did not receive regular antenatal care. The maternal mortality rate was 1.7%, and 61% was due to direct obstetric hemorrhage, including postpartum hemorrhage, Placenta abruption, and uterine rupture. Conclusion The study findings showed a slight increase in cesarean delivery rates during the study period. This rate is higher than the 10-15% recommended by the WHO in developing countries. Policies and efforts to decrease unnecessary cesarean sections should be promoted and implemented at each health facility.
Collapse
Affiliation(s)
- Ahmed Issak Hussein
- Obstetrics and Gynecology department, Mogadishu Somalia Turkish Training and Research Hospital, Mogadishu, Somalia,Correspondence: Ahmed Issak Hussein, Mogadishu Somalia Turkish Training and Research Hospital, Mogadishu, Somalia, Tel +252615597479, Email
| | - Sabri Kurtay
- Obstetrics and Gynecology department, Mogadishu Somalia Turkish Training and Research Hospital, Mogadishu, Somalia
| | - Abdikarim Ali Omar
- Obstetrics and Gynecology department, Mogadishu Somalia Turkish Training and Research Hospital, Mogadishu, Somalia
| | | | - Rahma Yusuf Haji Mohamud
- Obstetrics and Gynecology department, Mogadishu Somalia Turkish Training and Research Hospital, Mogadishu, Somalia
| |
Collapse
|
4
|
Khan B, Allah Yar R, Khakwani AK, Karim S, Arslan Ali H. Preeclampsia Incidence and Its Maternal and Neonatal Outcomes With Associated Risk Factors. Cureus 2022; 14:e31143. [DOI: 10.7759/cureus.31143] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/03/2022] [Indexed: 11/08/2022] Open
|
5
|
Silva AF, Afonso J, Sampaio A, Pimenta N, Lima RF, Castro HDO, Ramirez-Campillo R, Teoldo I, Sarmento H, González Fernández F, Kaczmarek A, Oniszczuk A, Murawska-Ciałowicz E. Differences in visual search behavior between expert and novice team sports athletes: A systematic review with meta-analysis. Front Psychol 2022; 13:1001066. [PMID: 36211897 PMCID: PMC9536317 DOI: 10.3389/fpsyg.2022.1001066] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2022] [Accepted: 08/01/2022] [Indexed: 12/01/2022] Open
Abstract
Background For a long time, in sports, researchers have tried to understand an expert by comparing them with novices, raising the doubts if the visual search characteristics distinguish experts from novices. Therefore, the aim of the present study was to review and conduct a meta-analysis to evaluate the differences in visual search behavior between experts and novices in team sports athletes. Methods This systematic review with meta-analysis followed the PRISMA 2020 and Cochrane's guidelines. Healthy team athletes were included, which engaged in regular practice, from any sex or competitive level, specifically classified a priori as expert or novice in the original research (i.e., if they were classified after the experiment, based on one of the tests, the study would be excluded). We considered only research published in peer-reviewed journals, with no limitations regarding date or language. It was considered healthy team sport athletes engaged in regular practice. The scenarios could be in situ or film-based. The databases of EBSCO (Academic Search Complete, Academic Search Ultimate, APA PsycArticles, and APA PsycINFO), PubMed, Scopus, SPORTDiscus, and Web of Science were used to perform the searches. The risk of bias was calculated through the RoBANS tool. Results From a total of 6,257 records, of which 985 were duplicates, titles and abstracts of 5,272 were screened, and 45 required full-text analysis. Of those, 23 were excluded due to not fulfilling the eligibility criteria regarding participants. In the end, 22 studies were selected, however, as two studies were part of the same trial and were analyzed conjointly. Discussion Experts showed to be older and with more years of practice. The ability to distinguish experts from novices was not so clear regarding the variables analyzed. This could be due to the strategies chosen in each study, which were specific to each scenario, and when grouping all together, it was lost information within non-representative averages. The distinction between experts and novices was not clear, showing a lot of heterogeneity in the included studies. The expert classification itself may have been the conditioning aspect for these results, retaining the doubt and the need for more studies in the field. Systematic review registration The protocol was pre-registered in OSF (project https://osf.io/3j4qv/, register https://osf.io/dvk2n).
Collapse
Affiliation(s)
- Ana Filipa Silva
- Escola Superior Desporto e Lazer, Instituto Politécnico de Viana do Castelo, Viana do Castelo, Portugal
- The Research Centre in Sports Sciences, Health Sciences and Human Development (CIDESD), Vila Real, Portugal
- Sport Performance, Recreation, Innovation and Technology (SPRINT), Melgaço, Portugal
| | - José Afonso
- Faculty of Sport, Centre of Research, Education, Innovation, and Intervention in Sport (CIFI2D), University of Porto, Porto, Portugal
| | | | - Nuno Pimenta
- Sport Performance, Recreation, Innovation and Technology (SPRINT), Melgaço, Portugal
- N2i, Polytechnic Institute of Maia, Maia, Portugal
| | - Ricardo Franco Lima
- Escola Superior Desporto e Lazer, Instituto Politécnico de Viana do Castelo, Viana do Castelo, Portugal
- The Research Centre in Sports Sciences, Health Sciences and Human Development (CIDESD), Vila Real, Portugal
- Sport Performance, Recreation, Innovation and Technology (SPRINT), Melgaço, Portugal
| | | | - Rodrigo Ramirez-Campillo
- Department of Physical Activity Sciences, Universidad de Los Lagos, Santiago, Chile
- Exercise and Rehabilitation Sciences Institute, School of Physical Therapy, Faculty of Rehabilitation Sciences, Universidad Andres Bello, Santiago, Chile
| | - Israel Teoldo
- Centre of Research and Studies in Soccer (NUPEF), Universidade Federal de Viçosa, Viçosa, Brazil
| | - Hugo Sarmento
- University of Coimbra, Research Unit for Sport and Physical Activity (CIDAF), Faculty of Sport Sciences and Physical Education, Coimbra, Portugal
| | | | - Agnieszka Kaczmarek
- Department of Physiology and Biochemistry, University School of Physical Education, Wrocław, Poland
| | - Anna Oniszczuk
- Department of Physiology and Biochemistry, University School of Physical Education, Wrocław, Poland
| | | |
Collapse
|
6
|
Davidson B, Bajpai D, Shah S, Jones E, Okyere P, Wearne N, Gumber R, Saxena N, Osafo C. Pregnancy-Associated Acute Kidney Injury in Low-Resource Settings: Progress Over the Last Decade. Semin Nephrol 2022; 42:151317. [PMID: 37011566 PMCID: PMC10986622 DOI: 10.1016/j.semnephrol.2023.151317] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/03/2023]
Abstract
Despite immense global effort, the maternal mortality rate in low-resource settings remains unacceptably high. Globally, this reflects the grave inequalities in access to health and reproductive services. Pregnancy-associated acute kidney injury (PRAKI) is an independent risk factor for mortality. The reported incidence of PRAKI in low- and middle-income countries is higher than that of high-income countries (4%-26% versus 1%-2.8%, respectively). Hypertensive disorders are now the leading cause of PRAKI in many regions, followed by hemorrhage and sepsis. PRAKI in low-resource settings carries a high mortality for both mother and child. Outcome studies suggest that PRAKI is associated with residual kidney dysfunction and may lead to dialysis dependence. This can be a death sentence in many regions with limited kidney replacement therapy. This review will summarize data on PRAKI on the African, Latin American, and Asian continents over the past decade. It will include the progress in published data, mortality, and treatment interventions and provide recommendations for the next decade.
Collapse
Affiliation(s)
- Bianca Davidson
- Department of Medicine, University of Cape Town, Cape Town, South Africa; Division of Hypertension and Nephrology, Groote Schuur Hospital, Cape Town, South Africa
| | - Divya Bajpai
- Department of Nephrology, Seth G.S.M.C. & K.E.M. Hospital, Mumbai, India
| | - Silvi Shah
- Division of Nephrology and Hypertension, Department of Internal Medicine, University of Cincinnati, Cincinnati, Ohio, United States
| | - Erika Jones
- Department of Medicine, University of Cape Town, Cape Town, South Africa; Division of Hypertension and Nephrology, Groote Schuur Hospital, Cape Town, South Africa
| | - Perditer Okyere
- Department of Internal Medicine, School of Medicine and Dentistry, College of Health Science, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana; Nephrology Unit, Komfo Anokye Teaching Hospital, Kumasi, Ghana
| | - Nicola Wearne
- Department of Medicine, University of Cape Town, Cape Town, South Africa; Division of Hypertension and Nephrology, Groote Schuur Hospital, Cape Town, South Africa
| | - Ramnika Gumber
- Division of Nephrology, Department of Internal Medicine, University of Michigan, Ann Arbor, Michigan, United States
| | - Nikhil Saxena
- Department of Nephrology, Seth G.S.M.C. & K.E.M. Hospital, Mumbai, India
| | - Charlotte Osafo
- Department of Medicine and Therapeutics, University of Ghana Medical School, University of Ghana, Accra Ghana; Department of Nephrology, The Bank Hospital, Accra Ghana.
| |
Collapse
|
7
|
Madaan S, Jaiswal A, Acharya N, Tayade S, Dhok A, Kumar S, Acharya S, Dewani D, Talwar D, Halani D, Reddy Eleti M. Role of Salivary Uric Acid Versus Serum Uric Acid in Predicting Maternal Complications of Pre-Eclampsia in a Rural Hospital in Central India: A Two-Year, Cross-Sectional Study. Cureus 2022; 14:e23360. [PMID: 35475103 PMCID: PMC9020463 DOI: 10.7759/cureus.23360] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/21/2022] [Indexed: 11/06/2022] Open
Abstract
Background Hypertensive disorders during pregnancy are an important topic of concern, specifically in rural and remote areas of India where there is a lack of awareness and it is difficult to maintain proper follow-up of pregnant females to screen them for complications developed during pregnancy. Gestational hypertension and pre-eclampsia result in the abruption of the placenta, hemolysis, elevated liver enzymes, low platelet count syndrome, eclampsia, and disseminated intravascular coagulation, which can be a serious threat to the health of the mother and the fetus. Therefore, it is important to identify biomarkers for diagnosing and predicting the complications of pre-eclampsia that may aid the obstetric high-dependency units based in rural areas to tackle this important health hazard during pregnancy. Methodology A total of 180 singleton pregnant women of more than 34 weeks of gestational age were enrolled in this study. All women were divided into three groups (control group, severe pre-eclampsia, and non-severe pre-eclampsia) based on the severity of blood pressure and the presence of proteinuria (≥+1 by the dipstick method). Salivary and serum uric acid levels were measured through morning samples, and all patients were monitored for the development of complications and outcomes. Salivary uric acid and serum uric acid levels were correlated with each other and with maternal complications of pre-eclampsia. Results Mean salivary uric acid (mg/dL) in severe pre-eclampsia was (6.72 ± 0.49) significantly higher compared to non-severe pre-eclampsia (4.75 ± 0.94) and control (3.13 ± 0.43). Mean serum uric acid (mg/dL) in severe pre-eclampsia was (8.13 ± 0.87) significantly higher compared to non-severe pre-eclampsia (6.23 ± 0.76) and control (3.85 ± 0.46).The lowest best cut-off value of maternal salivary uric acid was 5.06 mg/dL, above which one can predict maternal complications with a diagnostic accuracy of 78.33%. Conclusions Salivary uric acid and serum uric acid levels are significantly raised in cases of pre-eclampsia in comparison to normal pregnancy. Salivary uric acid and serum uric acid are correlated significantly indicating that salivary uric acid can function as a cost-effective, novel marker to provide an idea about serum uric acid levels. The prognostic accuracy of salivary uric acid was good in predicting maternal complications among cases of pre-eclampsia (severe and non-servere) and early-onset maternal complications. Therefore, it may be utilized as a helpful marker to identify high-risk patients.
Collapse
|