ObjectiveTo determine the risk of recurrent spontaneous preterm birth (sPTB) following sPTB in singleton pregnancies.DesignSystematic review and meta-analysis using random effects models.Data sourcesAn electronic literature search was conducted in OVID Medline (1948–2017), Embase (1980–2017) and ClinicalTrials.gov (completed studies effective 2017), supplemented by hand-searching bibliographies of included studies, to find all studies with original data concerning recurrent sPTB.Study eligibility criteriaStudies had to include women with at least one spontaneous preterm singleton live birth (<37 weeks) and at least one subsequent pregnancy resulting in a singleton live birth. The Newcastle-Ottawa Scale was used to assess study quality.ResultsOverall, 32 articles involving 55 197 women, met all inclusion criteria. Generally studies were well conducted and had a low risk of bias. The absolute risk of recurrent sPTB at <37 weeks’ gestation was 30% (95% CI 27% to 34%). The risk of recurrence due to preterm premature rupture of membranes (PPROM) at <37 weeks gestation was 7% (95% CI 6% to 9%), while the risk of recurrence due to preterm labour (PTL) at <37 weeks gestation was 23% (95% CI 13% to 33%).ConclusionsThe risk of recurrent sPTB is high and is influenced by the underlying clinical pathway leading to the birth. This information is important for clinicians when discussing the recurrence risk of sPTB with their patients.
Neurodevelopmental disorders (NDDs) are a heterogeneous group of conditions including intellectual disability, global developmental delay, autism spectrum disorder, and attention deficit hyperactivity disorder. Advances in genetic diagnostic technology have led to the identification of a number of NDD‐associated genes, but reports of cognitive and developmental outcomes in affected individuals have been variable. The objective of this scoping review is to synthesize available information pertaining to the developmental outcomes of individuals with pathogenic variants in ten emerging recurrent NDD‐associated genes identified from large scale sequencing studies; ADNP, ANKRD11, ARID1B, CHD2, CHD8, CTNNB1, DDX3X, DYRK1A, SCN2A, and SYNGAP1. After a comprehensive search, 260 articles were selected that reported on neurodevelopmental measures or diagnoses. We identify the spectrum of developmental outcomes for each genetic NDD, including prevalence of intellectual disability, frequency of co‐morbid NDDs such as ADHD and autism, and commonly reported medical issues that can help inform diagnosis and treatment. There are significant gaps in our understanding of the natural history of these conditions. Future research focusing on barriers to assessment, the development of modified assessment tools appropriate for long‐term outcomes in genetic NDD, and collection of longitudinal data will increase understanding of prognosis in these conditions and inform evaluations of treatment.
IntroductionIt is recognized that for individuals living with endometriosis, receiving a diagnosis is psychosocially beneficial, but little is known about whether this is influenced by the way in which the disease is diagnosed. The primary objective of this study was to determine the impact of the diagnostic test method (clinical, diagnostic imaging, or diagnostic laparoscopy) of endometriosis on the individual's sense of control over their disease and their perceived access to social supports. The secondary objectives were to identify the impact of the diagnostic method on perceived social support, and to explore if there was a difference in the diagnostic method utilization between countries.Material and MethodsThis retrospective cohort study reports on data collected using the Endometriosis Health Profile‐30 (EHP‐30) section of a previously published larger survey conducted between May and July 2020. Women aged 18–55 years who had received a diagnosis of endometriosis were recruited by social media platforms. The two domains of interest on the EHP‐30 were control and powerlessness and social support. Scores on these domains were analyzed with diagnosis method as the variable of interest.ResultsIn all, 1634 valid survey responses were received. There was a small statistically significant difference found between control and powerlessness scores for patients that received a diagnosis via imaging (ultrasound/MRI; n = 120) versus clinical diagnosis (n = 121) (p = 0.049). However, this did not reach clinical significance when covariates were controlled for (p = 0.054). No other comparisons reached statistical significance.ConclusionsThe diagnostic method of endometriosis does not appear to have a clinically significant impact on an individual's sense of control over their disease nor their access to social supports. However, further research into these domains to delineate the true impact of the diagnostic method is required.
Objectives: To determine the impact of the diagnostic test method (clinical, diagnostic imaging, or diagnostic laparoscopy) of endometriosis on the individual's sense of control over their disease and their perceived access to social supports. Methods: This international retrospective cohort study reports on data collected by the validated Endometriosis Health Profile-30 (EHP-30) section of a larger survey conducted between May and July 2020. People aged 18-55 who had received a diagnosis of endometriosis were recruited by social media platforms. The two dimensions of interest on the EHP-30 were:1. control and powerlessness and 2. social support. Scores on these dimensions were analysed with diagnosis method as the variable of interest. Diagnostic method proportionality was also assessed as a secondary outcome by geographical region.Results: 1634 valid survey responses were received. There was a difference found between control and powerlessness scores for patients that received a diagnosis via imaging (ultrasound/magnetic resonance imaging) versus clinical diagnosis (P = 0.049). However, this did not reach significance when co-variates were controlled for (P = 0.054).No other comparisons between diagnostic method and EHP-30 dimension scores demonstrated a difference. There was a statistically significant (P < 0.0001) difference in the rate of utilisation of the various diagnostic imaging techniques between geographical regions with diagnostic imaging being relatively uncommon and surgery being the most common method of diagnosis. Conclusions:The diagnostic method of endometriosis does not appear to have a clinically significant impact on an individual's sense of control over their disease nor their access to social supports. However, further research into these dimensions to delineate the true impact of the diagnostic method is required. OP06.13Changes in endometriomas over time in premenopausal non-pregnant women
Objectives: To determine the impact of the diagnostic test method (clinical, diagnostic imaging, or diagnostic laparoscopy) of endometriosis on the individual’s sense of control over their disease and their perceived access to social supports. Design: Retrospective cohort study. Setting: International. Population: 1,634 people aged 18-55 who had received a diagnosis of endometriosis. Methods: This study reports on data collected by the validated Endometriosis Health Profile-30 (EHP-30) section of a larger survey conducted between May and July 2020. Participants were recruited by social media platforms. Scores on the dimensions of interest were analysed with diagnostic method as the variable of interest. Diagnostic method proportionality was also assessed as a secondary outcome by geographical region. Main Outcome Measures: Scores on the dimensions of control and powerlessness and social support on the EHP-30. Results: There was a difference between control and powerlessness scores for patients that received a diagnosis via imaging (ultrasound/magnetic resonance imaging) versus clinical diagnosis (P=0.049). However, this did not reach significance when co-variates were controlled for (P=0.054). No other comparisons between diagnostic method and EHP-30 scores demonstrated a difference. There was a statistically significant (P<0.0001) difference in the rate of utilization of the various diagnostic imaging techniques between geographical regions with diagnostic imaging being relatively uncommon and surgery being the most common method of diagnosis. Conclusions: The diagnostic method of endometriosis does not appear to have a clinically significant impact on an individual’s sense of control over their disease nor their access to social supports.
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