Electrohysterogram for ANN-Based Prediction of Imminent Labor in Women with Threatened Preterm Labor Undergoing Tocolytic Therapy

[EN] Threatened preterm labor (TPL) is the most common cause of hospitalization in the second half of pregnancy and entails high costs for health systems. Currently, no reliable labor proximity prediction techniques are available for clinical use. Regular checks by uterine electrohysterogram (EHG) for predicting preterm labor have been widely studied. The aim of the present study was to assess the feasibility of predicting labor with a 7- and 14-day time horizon in TPL women, who may be under tocolytic treatment, using EHG and/or obstetric data. Based on 140 EHG recordings, artificial neural networks were used to develop prediction models. Non-linear EHG parameters were found to be more reliable than linear for differentiating labor in under and over 7/14 days. Using EHG and obstetric data, the <7- and <14-day labor prediction models achieved an AUC in the test group of 87.1 +/- 4.3% and 76.2 +/- 5.8%, respectively. These results suggest that EHG can be reliable for predicting imminent labor in TPL women, regardless of the tocolytic therapy stage. This paves the way for the development of diagnostic tools to help obstetricians make better decisions on treatments, hospital stays and admitting TPL women, and can therefore reduce costs and improve maternal and fetal wellbeing.This work was supported by the Spanish Ministry of Economy and Competitiveness, the European Regional Development Fund (MCIU/AEI/FEDER, UE RTI2018-094449-A-I00-AR) and by the Generalitat Valenciana (AICO/2019/220).Mas-Cabo, J.; Prats-Boluda, G.; Garcia-Casado, J.; Alberola Rubio, J.; Monfort-Ortiz, R.; Martinez-Saez, C.; Perales, A.... (2020). Electrohysterogram for ANN-Based Prediction of Imminent Labor in Women with Threatened Preterm Labor Undergoing Tocolytic Therapy. 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Dispersion Entropy: A Measure of Electrohysterographic Complexity for Preterm Labor Discrimination

[EN] Although preterm labor is a major cause of neonatal death and often leaves health sequels in the survivors, there are no accurate and reliable clinical tools for preterm labor prediction. The Electrohysterogram (EHG) has arisen as a promising alternative that provides relevant information on uterine activity that could be useful in predicting preterm labor. In this work, we optimized and assessed the performance of the Dispersion Entropy (DispEn) metric and compared it to conventional Sample Entropy (SampEn) in EHG recordings to discriminate term from preterm deliveries. For this, we used the two public databases TPEHG and TPEHGT DS of EHG recordings collected from women during regular checkups. The 10th, 50th and 90th percentiles of entropy metrics were computed on whole (WBW) and fast wave high (FWH) EHG bandwidths, sweeping the DispEn and SampEn internal parameters to optimize term/preterm discrimination. The results revealed that for both the FWH and WBW bandwidths the best separability was reached when computing the 10th percentile, achieving a p-value (0.00007) for DispEn in FWH, c = 7 and m = 2, associated with lower complexity preterm deliveries, indicating that DispEn is a promising parameter for preterm labor prediction.This work was supported by the Spanish ministry of economy and competitiveness, the European Regional Development Fund (MCIU/AEI/FEDER, UE RTI2018-094449-A-I00-AR) and the Generalitat Valenciana (AICO/2019/220).Nieto-Del-Amor, F.; Ye Lin, Y.; Garcia-Casado, J.; Díaz-Martínez, MDA.; González Martínez, M.; Monfort-Ortiz, R.; Prats-Boluda, G. (2021). Dispersion Entropy: A Measure of Electrohysterographic Complexity for Preterm Labor Discrimination. SCITEPRESS. 260-267. https://doi.org/10.5220/0010316602600267S26026

A Large-Scale Genetic Analysis Reveals a Strong Contribution of the HLA Class II Region to Giant Cell Arteritis Susceptibility

We conducted a large-scale genetic analysis on giant cell arteritis (GCA), a polygenic immune-mediated vasculitis. A case-control cohort, comprising 1,651 case subjects with GCA and 15,306 unrelated control subjects from six different countries of European ancestry, was genotyped by the Immunochip array. We also imputed HLA data with a previously validated imputation method to perform a more comprehensive analysis of this genomic region. The strongest association signals were observed in the HLA region, with rs477515 representing the highest peak (p = 4.05 × 10−40, OR = 1.73). A multivariate model including class II amino acids of HLA-DRβ1 and HLA-DQα1 and one class I amino acid of HLA-B explained most of the HLA association with GCA, consistent with previously reported associations of classical HLA alleles like HLA-DRB1∗04. An omnibus test on polymorphic amino acid positions highlighted DRβ1 13 (p = 4.08 × 10−43) and HLA-DQα1 47 (p = 4.02 × 10−46), 56, and 76 (both p = 1.84 × 10−45) as relevant positions for disease susceptibility. Outside the HLA region, the most significant loci included PTPN22 (rs2476601, p = 1.73 × 10−6, OR = 1.38), LRRC32 (rs10160518, p = 4.39 × 10−6, OR = 1.20), and REL (rs115674477, p = 1.10 × 10−5, OR = 1.63). Our study provides evidence of a strong contribution of HLA class I and II molecules to susceptibility to GCA. In the non-HLA region, we confirmed a key role for the functional PTPN22 rs2476601 variant and proposed other putative risk loci for GCA involved in Th1, Th17, and Treg cell function

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