Development and validation of a prognostic model to predict birth weight: individual participant data meta-analysis.

Autor:	Allotey J, Archer L, Snell KIE, Coomar D, Massé J, Sletner L, Wolf H, Daskalakis G, Saito S, Ganzevoort W, Ohkuchi A, Mistry H, Farrar D, Mone F, Zhang J, Seed PT, Teede H, Da Silva Costa F, Souka AP, Smuk M, Ferrazzani S, Salvi S, Prefumo F, Gabbay-Benziv R, Nagata C, Takeda S, Sequeira E, Lapaire O, Cecatti JG, Morris RK, Baschat AA, Salvesen K, Smits L, Anggraini D, Rumbold A, van Gelder M, Coomarasamy A, Kingdom J, Heinonen S, Khalil A, Goffinet F, Haqnawaz S, Zamora J, Riley RD, Thangaratinam S, Kwong A, Savitri AI, Bhattacharya S, Uiterwaal CS, Staff AC, Andersen LB, Olive EL, Redman C, Macleod M, Thilaganathan B, Ramírez JA, Audibert F, Magnus PM, Jenum AK, McAuliffe FM, West J, Askie LM, Zimmerman PA, Riddell C, van de Post J, Illanes SE, Holzman C, van Kuijk SMJ, Carbillon L, Villa PM, Eskild A, Chappell L, Velauthar L, van Oostwaard M, Verlohren S, Poston L, Ferrazzi E, Vinter CA, Brown M, Vollebregt KC, Langenveld J, Widmer M, Haavaldsen C, Carroli G, Olsen J, Zavaleta N, Eisensee I, Vergani P, Lumbiganon P, Makrides M, Facchinetti F, Temmerman M, Gibson R, Frusca T, Norman JE, Figueiró-Filho EA, Laivuori H, Lykke JA, Conde-Agudelo A, Galindo A, Mbah A, Betran AP, Herraiz I, Trogstad L, Smith GGS, Steegers EAP, Salim R, Huang T, Adank A, Meschino WS, Browne JL, Allen RE, Klipstein-Grobusch K, Crowther CA, Jørgensen JS, Forest JC, Mol BW, Giguère Y, Kenny LC, Odibo AO, Myers J, Yeo S, McCowan L, Pajkrt E, Haddad BG, Dekker G, Kleinrouweler EC, LeCarpentier É, Roberts CT, Groen H, Skråstad RB, Eero K, Pilalis A, Souza RT, Hawkins LA, Figueras F, Crovetto F
Jazyk:	angličtina
Zdroj:	BMJ medicine [BMJ Med] 2024 Aug 14; Vol. 3 (1), pp. e000784. Date of Electronic Publication: 2024 Aug 14 (Print Publication: 2024).
DOI:	10.1136/bmjmed-2023-000784
Abstrakt:	Objective: To predict birth weight at various potential gestational ages of delivery based on data routinely available at the first antenatal visit. Design: Individual participant data meta-analysis. Data Sources: Individual participant data of four cohorts (237 228 pregnancies) from the International Prediction of Pregnancy Complications (IPPIC) network dataset. Eligibility Criteria for Selecting Studies: Studies in the IPPIC network were identified by searching major databases for studies reporting risk factors for adverse pregnancy outcomes, such as pre-eclampsia, fetal growth restriction, and stillbirth, from database inception to August 2019. Data of four IPPIC cohorts (237 228 pregnancies) from the US (National Institute of Child Health and Human Development, 2018; 233 483 pregnancies), UK (Allen et al, 2017; 1045 pregnancies), Norway (STORK Groruddalen research programme, 2010; 823 pregnancies), and Australia (Rumbold et al, 2006; 1877 pregnancies) were included in the development of the model. Results: The IPPIC birth weight model was developed with random intercept regression models with backward elimination for variable selection. Internal-external cross validation was performed to assess the study specific and pooled performance of the model, reported as calibration slope, calibration-in-the-large, and observed versus expected average birth weight ratio. Meta-analysis showed that the apparent performance of the model had good calibration (calibration slope 0.99, 95% confidence interval (CI) 0.88 to 1.10; calibration-in-the-large 44.5 g, -18.4 to 107.3) with an observed versus expected average birth weight ratio of 1.02 (95% CI 0.97 to 1.07). The proportion of variation in birth weight explained by the model (R 2 ) was 46.9% (range 32.7-56.1% in each cohort). On internal-external cross validation, the model showed good calibration and predictive performance when validated in three cohorts with a calibration slope of 0.90 (Allen cohort), 1.04 (STORK Groruddalen cohort), and 1.07 (Rumbold cohort), calibration-in-the-large of -22.3 g (Allen cohort), -33.42 (Rumbold cohort), and 86.4 g (STORK Groruddalen cohort), and observed versus expected ratio of 0.99 (Rumbold cohort), 1.00 (Allen cohort), and 1.03 (STORK Groruddalen cohort); respective pooled estimates were 1.00 (95% CI 0.78 to 1.23; calibration slope), 9.7 g (-154.3 to 173.8; calibration-in-the-large), and 1.00 (0.94 to 1.07; observed v expected ratio). The model predictions were more accurate (smaller mean square error) in the lower end of predicted birth weight, which is important in informing clinical decision making. Conclusions: The IPPIC birth weight model allowed birth weight predictions for a range of possible gestational ages. The model explained about 50% of individual variation in birth weights, was well calibrated (especially in babies at high risk of fetal growth restriction and its complications), and showed promising performance in four different populations included in the individual participant data meta-analysis. Further research to examine the generalisability of performance in other countries, settings, and subgroups is required. Trial Registration: PROSPERO CRD42019135045. Competing Interests: All authors have completed the ICMJE uniform disclosure form at www.icmje.org/disclosure-of-interest/ and declare: support from the National Institute for Health and Care Research Health Technology Assessment UK programme for the submitted work; no financial relationships with any organisations that might have an interest in the submitted work in the previous three years; no other relationships or activities that could appear to have influenced the submitted work. (Copyright © Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)
Databáze:	MEDLINE
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