Cluster analysis identifying clinical phenotypes of preterm birth and related maternal and neonatal outcomes from the Brazilian Multicentre Study on Preterm Birth. Issue 1 (21st May 2019)

• Record Type: Journal Article
• Authors: Souza, Renato T.; Cecatti, Jose G.; Passini, Renato; Pacagnella, Rodolfo C.; Oliveira, Paulo F.; Silva, Cleide M.
• Other Names: Tedesco Ricardo P. investigator.; Lajos Giuliane J. investigator.; Nomura Marcelo L. investigator.; Rehder Patricia M. investigator.; Dias Tabata Z. investigator.; Costa Maria L. investigator.; Haddad Samira M. investigator.; Marba Sergio T. investigator.; Guinsburg Ruth investigator.; Martinez Francisco E. investigator.; Zotarelli Vilma investigator.; Gurgel Lucio T. investigator.; Feitosa Francisco E. investigator.; Chaves George N. investigator.; Porto Ana M. investigator.; Coutinho Isabela C. investigator.; Barbosa Lima Antonio C. investigator.; Melo Elias F. investigator.; Leite Débora F. investigator.; Amorim Melania M. investigator.; Melo Adriana S.O. investigator.; Melo Fabiana O. investigator.; Martins Marília G. investigator.; Nunes Marynea V. investigator.; Paiva Cláudio S. investigator.; Lima Moises D. investigator.; Freire Djacyr M. investigator.; Tristão Edson G. investigator.; Nascimento Denis J. investigator.; Menezes Carlos A. investigator.; Aquino Marcelo investigator.; Vettorazzi Janete investigator.; Senger Cintia E. investigator.; Assumpção Augusta M.B. investigator.; Guedes Marcela A. F. investigator.; Moreira Maria E. L. investigator.; Borges Vera T. investigator.; Maia Filho Nelson L. investigator.; Mathias Jacinta P. investigator.; Souza Eduardo investigator.; Zamarian Ana C.P. investigator.; Quintana Silvana M. investigator.; Melli Patrícia P.S. investigator.; Lotufo Fátima A. investigator.; Uzilin Kaliane investigator.; Zanette Elvira A. investigator.; Andreucci Carla B. investigator.; Oliveira Tenilson A. investigator.; Oliveira Laércio R. investigator.; Santos Marcos A. N. investigator.; Sass Nelson investigator.; Silveira Mirian R. F. investigator.; Coutinho Pedro R. investigator.; Siqueira Luciana investigator.;
• Is Part Of: International journal of gynaecology and obstetrics. Volume 146:Issue 1(2019)
• Page Start: 110
• Page End: 117
• Publication Date: 2019-05-21
• Subjects: Cluster -- k‐means -- Maternal outcomes -- Neonatal outcomes -- Phenotypes -- Preterm birth; Gynecology -- Periodicals; Obstetrics -- Periodicals; Electronic journals; 618
• DOI: 10.1002/ijgo.12839
• Languages: English
• ISSNs: 0020-7292

Abstract

Abstract: 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. Abstract : In clustering analysis, different subtypes of preterm delivery had different maternal and pregnancy characteristics, and different clusters had similar maternal or perinatal outcomes.