Correlation of anti-phosphatidylethanolamine antibodies with premature birth in women with a history of miscarriage: a retrospective study

Objective
The objective is to examine the correlation of anti-phosphatidylethanolamine (aPE) antibodies with premature birth. Premature birth is an important risk factor for infant mortality and subsequent development of mental, metabolic and cardiovascular diseases. However, the risk factors associated with preterm birth are not well understood. aPE antibodies are an anti-phospholipid autoantibody that is thought to be a factor in pathological pregnancy. However, aPE antibodies have not been included in the classification criteria for antiphospholipid syndrome. Therefore, we aimed to check the clinical significance of aPE antibodies in association with premature birth.

Design
We conducted a retrospective analysis of 442 pregnant women who had experienced at least one unexplained miscarriage and were tested for aPE antibodies and compared their clinical characteristics, coagulation indicators, immune biomarkers and pregnancy outcomes. Logistic regression analysis was employed to identify factors associated with premature birth.

Setting
Ruian City, Wenzhou, Zhejiang Province, China.

Participants
A total of 442 patients with ultrasound-confirmed intrauterine pregnancy from the Third Affiliated Hospital of Wenzhou Medical University between May 2018 and December 2022 were retrospectively selected and included in the study. The inclusion criteria were as follows: having been tested for aPE and having experienced at least one unexplained miscarriage. The exclusion criteria were as follows: (a) incomplete clinical records, (b) being positive for typical antiphospholipid antibodies (aPL, aβ2-GP1 and LA), (c) hormone or metabolic disorder, (d) lost to follow-up, (e) known clinical autoimmune diseases, (f) severe reproductive system infection or malformation, (g) fetal loss: pregnancy loss before 24 weeks and (h) multiple pregnancy. In this study, preterm birth was defined as birth before 37 weeks.

Primary and secondary outcome measures
We enrolled 442 patients in our study: 60 pregnancies with premature birth and 382 pregnancies with term birth.

Results
Our findings revealed that among the 442 participants, 13.6% had a premature birth (

Leggi
Aprile 2025

Replicating a COVID-19 study in a national England database to assess the generalisability of research with regional electronic health record data

Objectives
To assess the degree to which we can replicate a study between a regional and a national database of electronic health record data in the UK. The original study examined the risk factors associated with hospitalisation following COVID-19 infection in people with diabetes.

Design
A replication of a retrospective cohort study.

Setting
Observational electronic health record data from primary and secondary care sources in the UK. The original study used data from a large, urbanised region (Greater Manchester Care Record, Greater Manchester, UK—2.8 m patients). This replication study used a national database covering the whole of England, UK (NHS England’s Secure Data Environment service for England, accessed via the BHF Data Science Centre’s CVD-COVID-UK/COVID-IMPACT Consortium—54 m patients).

Participants
Individuals with a diagnosis of type 1 diabetes or type 2 diabetes prior to a positive COVID-19 test result. The matched controls (3:1) were individuals who had a positive COVID-19 test result, but who did not have a diagnosis of diabetes on the date of their positive COVID-19 test result. Matching was done on age at COVID-19 diagnosis, sex and approximate date of COVID-19 test.

Primary and secondary outcome measures
Hospitalisation within 28 days of a positive COVID-19 test.

Results
We found that many of the effect sizes did not show a statistically significant difference, but that some did. Where effect sizes were statistically significant in the regional study, then they remained significant in the national study and the effect size was the same direction and of similar magnitude.

Conclusions
There is some evidence that the findings from studies in smaller regional datasets can be extrapolated to a larger, national setting. However, there were some differences, and therefore replication studies remain an essential part of healthcare research.

Leggi
Aprile 2025