American journal of perinatology最新文献

{"title":"Social Determinants of Health Associated with Intimate Partner Violence in an Urban Obstetric Population.","authors":"Christina R Kuhrau, Elizabeth Kelly, Emily A DeFranco","doi":"10.1055/a-2491-4269","DOIUrl":"10.1055/a-2491-4269","url":null,"abstract":"<p><p>Intimate partner violence (IPV) is pervasive and can lead to severe health consequences. In the United States, 25% of women have experienced sexual violence, physical violence, and/or stalking by an intimate partner. However, less is known about the frequency and risk factors for IPV in the obstetric population.Nested case-control study from a prospective cohort study of 606 parturients at a single academic medical center from 2011 to 2022. Structured questionnaires were administered to randomly chosen, consented patients during their postpartum hospital stay to gather information on social determinants of health (SDoH) and birth outcomes. The case group included participants who reported forced sex causing pregnancy, verbal abuse before or during pregnancy, or physical abuse during pregnancy. The control group reported none of these. Odds ratios were used to quantify the relationship between IPV and maternal sociodemographic characteristics, pregnancy factors, and levels of perceived support and discrimination.Of 606 study participants, 568 (94%) provided data on IPV. Of those, 20.4% reported IPV (case) and 80.6% reported no IPV (control). In total, 74.6% of the study population was enrolled prepandemic. Unmarried status, low income, food insecurity, housing insecurity, substance use during pregnancy, higher gravidity, unintended pregnancy, low social support, and racial and gender discrimination were all significantly associated with IPV; maternal race and pregnancy during the COVID-19 pandemic were not.IPV is common, reported by one in five parturients in our population. Although maternal race was not associated with IPV in this perinatal cohort, experiencing racism was. Initiatives aimed to address SDoH such as substance use, family planning, and access to food and housing remain key opportunities to support pregnant patients experiencing IPV. The connection between perceived discrimination and IPV found here highlights the importance of addressing the influence of racism and gender-based discrimination on adverse birth outcomes in the United States. · One in five parturients disclosed IPV.. · Racial discrimination was correlated with IPV.. · Food and housing insecurity increase IPV risk.. · COVID-19 did not increase the rate of IPV.. · Psychosocial support is vital during pregnancy..</p>","PeriodicalId":7584,"journal":{"name":"American journal of perinatology","volume":" ","pages":"1325-1332"},"PeriodicalIF":1.5,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142754567","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Novel Placental Biomarker Shows Predictive Potential for Spontaneous Preterm Labor.","authors":"Bingbing Wang, Karl Seif, Jun Lei, Mary Mangione, Sifa Turan, E Albert Reece, Irina Burd, Peixin Yang","doi":"10.1055/a-2491-4391","DOIUrl":"10.1055/a-2491-4391","url":null,"abstract":"<p><p>Human parturition involves many events among mother, fetus, and placenta, and the initiation of these events is the consequence of activation of a series of endocrine and immune responses. Multiple underlying pathways account for the cascade of events that culminate in spontaneous preterm labor. In this study, we aimed to characterize these signaling pathways of placental origin at molecular levels.We used single-cell RNA-sequencing (sc-RNA-seq) analysis to probe transcriptional heterogeneity in human placenta delivered at preterm or term and then used RNA in situ hybridization (RNA-ISH) assay on formalin-fixed paraffin-embedded (FFPE) placental tissues to validate these results.By using sc-RNA-seq on villous cytotrophoblast (CTB) isolated from a preterm placenta, we found that signaling pathways implicated in the initiation of term or preterm labor including ferroptosis, kisspeptin (<i>KISS1</i>), and senescence were constitutively activated in distinct cellular clusters of these trophoblastic stem cells. RNA-ISH-based spatial gene expression profiling in FFPE tissues revealed that pregnancy-specific beta-1-glycoprotein 4 (PSG4), a potent molecular driver for cellular aging, was significantly increased in preterm placentas (<i>N</i> = 30) compared to their full-term counterparts (<i>N</i> = 9). Furthermore, <i>PSG4</i> mRNA signals were predominantly detected in the villous syncytiotrophoblast and the discontinuous monolayer of CTB as well as the intervillous space where maternal blood circulates.Our study provides strong support for <i>PSG4</i> overexpression serving as a biomarker for pregnant women at risk for preterm delivery, which can allow for the development of timely and clinical preventive strategies. · A sc-RNA-seq analysis on a preterm placenta identified multiple signaling pathways constitutively activated in distinct clusters of CTB.. · RNA-ISH assay uncovered that the mRNA levels of PSG4, a molecular driver for cellular senescence significantly increased in preterm placentas compared to the term counterparts.. · PSG4 mRNA signals were largely observed in the villous trophoblast as well as the intervillous space..</p>","PeriodicalId":7584,"journal":{"name":"American journal of perinatology","volume":" ","pages":"1333-1343"},"PeriodicalIF":1.5,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142754565","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Incidence of New, Nonphysiologic Maternal Findings on Fetal Magnetic Resonance Imaging.","authors":"Shirley J Shao, Andrew Grimes, Marley Rashad, Liina Poder, Dorothy Shum, Nasim C Sobhani","doi":"10.1055/a-2466-1319","DOIUrl":"10.1055/a-2466-1319","url":null,"abstract":"<p><p>Fetal magnetic resonance imaging (MRI) is increasingly used for evaluation of fetal anomalies, and rates of incidental maternal findings are not well characterized. Our objective was to evaluate the rate of incidental maternal findings at the time of antenatal MRI performed for fetal indications.This was a retrospective cohort study that included all fetal MRIs performed between 2018 and 2023 at a single tertiary care institution with a multidisciplinary fetal diagnosis and treatment center. The electronic medical record was reviewed to identify all documented maternal findings and any new, nonphysiologic maternal findings. The latter was defined as previously unknown abnormalities of maternal structures unrelated to normal physiology.Our study included 834 imaging events, performed at an average gestational age of 23 weeks. The most common indication for imaging was fetal anomaly (81.1%). The most common imaging type was fetal brain MRI (81.4%). Overall, 16.2% reported a maternal finding and 7% reported a new, nonphysiologic finding. The most common new, nonphysiologic findings were renal cysts (<i>n</i> = 11), liver cysts (<i>n</i> = 6), and gallstones or gallbladder sludge (<i>n</i> = 5). Compared with imaging events that included a fetal brain MRI, imaging events that included a fetal body MRI had a significantly higher rate of any maternal findings (53.0 vs. 10.4%, <i>p</i> < 0.001) and new, nonphysiologic maternal findings (26.9 vs. 3.7%, <i>p</i> < 0.001).Our results suggest that the risk of identifying new, nonphysiologic maternal findings on fetal MRI is low. The rate of any maternal and new, nonphysiologic maternal findings may differ by fetal MRI type due to differences in imaging depth and extent of radiology subspecialist review. These data should be incorporated into pretest counseling for patients planning to have fetal MRI. · The rate of incidental maternal findings on fetal MRI was 7%-lower than previously reported.. · Incidental maternal findings were more common on fetal body versus brain MRI.. · Maternal BMI did not impact incidence of new, nonphysiologic maternal findings.. · Our results could inform pretest counseling and consent discussions around fetal MRI..</p>","PeriodicalId":7584,"journal":{"name":"American journal of perinatology","volume":" ","pages":"1186-1191"},"PeriodicalIF":1.5,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142612353","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Fetal Growth Restriction: A Pragmatic Approach.","authors":"Allan Nadel, Malavika Prabhu, Anjali Kaimal","doi":"10.1055/a-2483-5684","DOIUrl":"10.1055/a-2483-5684","url":null,"abstract":"<p><p>An accurate diagnosis of fetal growth restriction relies on a precise estimation of gestational age based on a carefully obtained history as well as early ultrasound, since a difference of just a few days can lead to a significant error. There is a continuum of risk for adverse outcome that depends on the certainty of dates and presence or absence of comorbidities, in addition to the estimated fetal weight percentile and the umbilical artery waveform. The results of several studies, most notably the TRUFFLE trial, demonstrate that optimal management of fetal growth restriction with an abnormal umbilical artery waveform requires daily electronic fetal heart rate monitoring, and this monitoring does not require computerized interpretation. The role of ductus venosus waveform, biophysical profile, and middle cerebral artery waveform is less clear, and the results of these three modalities should be interpreted with caution. · A correct diagnosis of fetal growth restriction requires a very precise estimate of gestational age.. · In the presence of abnormal umbilical artery Doppler, the cornerstone of surveillance is daily electronic fetal heart rate monitoring.. · Surveillance with biophysical profile, ductus venosus waveform, and middle cerebral artery waveform are less important than daily electronic fetal heart rate monitoring..</p>","PeriodicalId":7584,"journal":{"name":"American journal of perinatology","volume":" ","pages":"1223-1228"},"PeriodicalIF":1.5,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12136975/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142715050","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Continuous versus Intermittent Blood Pressure Monitoring in Postpartum Preeclampsia with Severe Features.","authors":"Helen Woolcock Martinez, Noora Haghighi, Anne-Sophie van Wingerden, Michael Kirschner, Whitney A Booker, Natalie A Bello, Nils Petersen, Eliza C Miller","doi":"10.1055/a-2457-2781","DOIUrl":"10.1055/a-2457-2781","url":null,"abstract":"<p><p>In this study, we piloted the use of continuous 24-hour blood pressure (BP) monitoring in postpartum patients with preeclampsia with severe features.We measured continuous BP for up to 24 hours using finger plethysmography. We also used an oscillometric device to measure brachial BP per usual clinical protocol (intermittent BP) during the same monitoring period. Using a paired <i>t</i>-test, we compared mean BP values assessed using intermittent and continuous methods, and using McNemar's test, we compared the proportion of patients with sustained severe-range BP using each BP measurement method.A total of 25 patients were included in this study. There was no difference in mean systolic BP (SBP) and mean arterial pressure between intermittent and continuous BP measurements. Intermittently recorded mean diastolic BP (DBP) was significantly higher than continuously recorded DBP. Eleven participants (44%) had sustained SBP ≥160 mm Hg using continuous monitoring compared with two using intermittent monitoring (<i>p</i> = 0.003). Of these 11 participants, 3 (37%) also recorded sustained DBP ≥110 mm Hg using continuous monitoring compared with none using intermittent monitoring.Continuous BP monitoring is a feasible and reliable method for detecting sustained severe-range BP in postpartum patients receiving treatment for preeclampsia with severe features. · Postpartum continuous BP monitoring is feasible.. · Continuous BP detects more sustained severe BP.. · Continuous BP may be a reliable BP method..</p>","PeriodicalId":7584,"journal":{"name":"American journal of perinatology","volume":" ","pages":"1366-1370"},"PeriodicalIF":1.5,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12103628/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142563755","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Intrapartum Care for People with Diabetes-Working towards Evidence-Based Management.","authors":"Michal Fishel Bartal","doi":"10.1055/a-2405-1846","DOIUrl":"10.1055/a-2405-1846","url":null,"abstract":"<p><p>The consensus in the literature supports the need for careful monitoring and management of maternal blood glucose during labor to optimize neonatal outcomes. Guidelines generally recommend strict control of maternal blood glucose during labor, involving frequent checks, and the use of dextrose and insulin as needed. However, recent evidence has not consistently shown a strong association between strict control of blood glucose and a reduction in the rate of neonatal hypoglycemia. This raises questions about the extent to which intrapartum blood glucose control impacts neonatal hypoglycemia. This review aims to explore the literature on intrapartum maternal blood glucose management in individuals with pregestational or gestational diabetes, utilizing peer-reviewed journals and datasets, including PubMed, Google Scholar, and clinical guidelines. Observational studies, small sample sizes, variability in definitions of maternal hyperglycemia and neonatal hypoglycemia, and differences in measurement methods such as timing and thresholds for intervention limit the literature on this topic. Additionally, many studies may not fully account for confounding factors such as maternal body mass index, diet, and other comorbidities affecting blood glucose levels. These limitations underscore the need for a cautious interpretation of current findings and highlight the necessity for future research in this area. This review elaborates on the available data and summarizes evidence on managing labor in pregnancies complicated by diabetes. We also emphasize the need for further research to clarify the relationship between maternal blood glucose during labor and neonatal blood glucose. · The benefits of strict intrapartum blood glucose control are unclear.. · The optimal maternal blood glucose range to prevent neonatal hypoglycemia remains undefined.. · Additional research is necessary to understand the relationship between maternal and neonatal blood glucose..</p>","PeriodicalId":7584,"journal":{"name":"American journal of perinatology","volume":" ","pages":"1103-1108"},"PeriodicalIF":1.5,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142103504","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Integrating Stakeholder Priorities for the Optimization of Care of the Preterm Infant in a Safety-Net NICU.","authors":"Elizabeth Sewell, Miguel Locsin, George Bugg, Kimarie Bugg, Kate McGinnis, Mary Jackson, Nathalie Maitre, Sierra Peagler, Dana Robinson, Andrea Serano, Jessica Roberts","doi":"10.1055/a-2463-4327","DOIUrl":"10.1055/a-2463-4327","url":null,"abstract":"<p><p>This study aimed to engage clinical and community stakeholders to create a prioritization matrix of interventions to reduce neonatal brain injury and improve neurodevelopmental outcomes.We collaborated with our community partner to establish a Lived Experience Advisory Group (LEAG). Faculty performed a literature review to identify neonatal neuroprotective interventions; additional priorities from the LEAG were also included. Project leaders scored and presented intervention bundles for impact. Stakeholder priorities for value/feasibility were obtained via questionnaire. Mean values were incorporated into a prioritization matrix.Themes from discussions with LEAG members included the role of the neonatal intensive care unit (NICU) parent, the experience of trauma, shared decision-making, communication and trust with the health care team, and bias in medical care. Five interventions were placed in the highest priority quadrant of the prioritization matrix: thermoregulation, maternal antepartum steroids, delayed cord clamping, optimized oxygen delivery, and optimized glucose regulation.It is feasible to incorporate community and parent values into clinically oriented neuroprotective intervention bundles for preterm infants. This clinical-community collaboration is vital to ensure that our project objectives meet the needs and priorities of the population it is intended to serve. · Including input from parent advisory groups supports interventions that meet the needs of families.. · Collaboration between clinical and community stakeholders can improve neuroprotective and neurodevelopmental strategies.. · Incorporation of clinical interventions into a prioritization matrix improves resource utilization.. · Five perinatal interventions were ranked highly for impact and feasibility in the prioritization matrix..</p>","PeriodicalId":7584,"journal":{"name":"American journal of perinatology","volume":" ","pages":"1152-1161"},"PeriodicalIF":1.5,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142779215","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of Social Determinants of Health on Follow-up for Neonates Requiring Neurocritical Care.","authors":"Isabella Eiler, Lakeisha Boyd, Melissa Klitzman, Bittu Majmudar-Sheth, Beatrice M Stefanescu","doi":"10.1055/a-2486-8994","DOIUrl":"10.1055/a-2486-8994","url":null,"abstract":"<p><p>This study aimed exploration of associations of social determinants of health (SDH) with attrition rates of neurocritical care graduates at follow-up.An observational retrospective cohort study was conducted to evaluate the attrition rates of an infant's first appointment scheduled with the NeuroNICU follow-up clinic in correlation with SDH.The \"No Show\" group was more likely to have unemployed (<i>p</i> = 0.014), black or multiracial mothers (<i>p</i> = 0.005), public insurance (<i>p</i> < 0.001), lower gestational age (<i>p</i> < 0.001), live further from the clinic (0.011), and a lower zip code-associated income (<i>p</i> = 0.008). After controlling for driving time, race, and education, infants who had private insurance were 2.268 times more likely to attend their follow-up visit when compared with infants who had public insurance (<i>p</i> = 0.014).A significant SDH-related difference existed among the \"Show\" and \"No Show\" groups. Identifying these factors during neonatal intensive care unit (NICU) admission can facilitate targeted support for families while inpatient and promote improved outpatient follow-up. · Follow-up for neonates requiring neurocritical care is strongly influenced by social determinants.. · Standardized SDH screening in NICUs, identifying high-risk infants for attrition, is used by few.. · Factors influencing disparities in the utilization of follow-up programs require further study.. · Equity-based attrition prevention interventions could improve outcomes and reduce costs..</p>","PeriodicalId":7584,"journal":{"name":"American journal of perinatology","volume":" ","pages":"1295-1303"},"PeriodicalIF":1.5,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142724777","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Flat Oral Glucose Tolerance Test during Pregnancy and Risk for Type 2 Diabetes: A 5-Year Cohort Study.","authors":"Danit Tarashandegan, Amir Naeh, Mordechai Hallak, Yoel Toledano, Rinat Gabbay-Benziv, Esther Maor-Sagie","doi":"10.1055/a-2490-3183","DOIUrl":"10.1055/a-2490-3183","url":null,"abstract":"<p><p>This study aimed to evaluate the risk of type 2 diabetes mellitus (T2DM) in women with flat response in the 100-g oral glucose tolerance test (OGTT) performed during pregnancy in a large cohort of women with up to 5 years of follow-up.A retrospective analysis of women with documented OGTT during pregnancy and T2DM data up to 5 years after pregnancy. Gestational diabetes mellitus (GDM) screening was done by a two-step strategy. Glucose levels during pregnancy were extracted from the computerized laboratory system of Meuhedet Health Maintenance Organization (HMO) and cross-tabulated with the Israeli National Diabetes Registry. Flat OGTT was defined as fasting glucose <95 mg/dL and three postprandial values lower than 100 mg/dL. The cohort was stratified by OGTT results to normal glucose values, flat OGTT, and GDM according to Carpenter and Coustan thresholds. Cumulative risk for T2DM was evaluated and compared between groups. Statistical analysis included univariate analysis followed by survival analysis.A total of 14,122 parturients entered the analysis. Of them, 965 (6.8%) had flat OGTT, 11,427 (80.9%) had normal OGTT, and 1,730 (12.3%) had GDM. Women with flat OGTT were younger, had lower body mass index (BMI; kg/m²), and had lower rates of hypertension. Their glucose values throughout pregnancy were lower compared with the other groups (<i>p</i> < 0.001 for all). During the study period and following adjustment to maternal age, obesity, and hypertension, women with flat OGTT had a low incidence of T2DM, even when compared with women with normal OGTT (adjusted hazard ratio 0.212, 95% confidence interval 0.052-0.856).Parturients with flat OGTT during pregnancy are at a low risk of developing T2DM up to 5 years following pregnancy. · Women with flat OGTT are younger, with lower BMI and lower hypertension rates.. · During pregnancy, glucose levels were lower in flat OGTT women than in normal OGTT or GDM.. · Postpartum women with flat OGTT had lower risk of developing type 2 diabetes over 5 years..</p>","PeriodicalId":7584,"journal":{"name":"American journal of perinatology","volume":" ","pages":"1311-1317"},"PeriodicalIF":1.5,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142749750","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Derivation and Validation of Prediction of Preterm Preeclampsia Using Machine Learning Algorithms.","authors":"Tetsuya Kawakita, Juliana G Martins, Yara H Diab, Lea Nehme, George Saade","doi":"10.1055/a-2495-3600","DOIUrl":"10.1055/a-2495-3600","url":null,"abstract":"<p><p>This study aimed to develop machine learning (ML) models for predicting preterm preeclampsia using the information available before 23 weeks gestation.This was a secondary analysis of the Nulliparous Pregnancy Outcomes Study: Monitoring Mothers-to-Be (nuMoM2b) cohort. We considered 131 features available before 23 weeks including maternal demographics, obstetrics and family history, social determinants of health, physical activity, nutrition, and early second-trimester ultrasound. Our primary outcome was preterm preeclampsia before 37 weeks. The dataset was randomly split into a training set (70%) and a validation set (30%). ML models using glmnet, multilayer perceptron, random forest, XGBoost (extreme gradient boosting), and LightGBM models were developed. Using the ML approach that achieved the best area under the curve (AUC), we developed the final model. Further feature selection was conducted from the top 25 important features based on SHapley Additive exPlanations (SHAP) values. The performance of the final model was assessed using the validation dataset.Of 9,467 individuals, 219 (2.3%) had preterm preeclampsia. The AUC of the XGBoost model was the highest (AUC = 0.749 [95% confidence interval (95% CI), 0.736-0.762]) compared with other models. Therefore, XGBoost was used to develop models using fewer variables. The XGBoost model with the eight features (in order of importance: mean uterine artery pulsatility index in the early second trimester, chronic hypertension, pregestational diabetes, uterine artery notch, systolic and diastolic blood pressure in the first trimester, body mass index, and maternal age) was chosen as the final model as it had an AUC of 0.741 (95% CI, 0.730-0.752) which was not inferior to the original model (<i>p</i> = 0.58). The final model in the validation dataset had an AUC of 0.779 (95% CI, 0.722-0.831). An online application of the final model was developed ( https://kawakita.shinyapps.io/Preterm_preeclampsia/ ).ML algorithms using information available before 23 weeks can accurately predict preterm preeclampsia before 37 weeks. · Prediction models using uterine artery Doppler have not been adopted in the US.. · We developed a model using an ML algorithm.. · An online application of the final model was developed.. · ML algorithms using information available before 23 weeks can accurately predict preterm preeclampsia before 37 weeks..</p>","PeriodicalId":7584,"journal":{"name":"American journal of perinatology","volume":" ","pages":"1354-1361"},"PeriodicalIF":1.5,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142779181","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}