To develop and validate a machine-learning model for predicting preterm birth in pregnant women with gestational diabetes mellitus and hypertensive disorders.
Key Findings:
The Naive Bayes model showed the best balance of discrimination, interpretability, and robustness among evaluated algorithms.
Five significant predictors were identified: alanine transaminase, aspartate transaminase, albumin, lactate dehydrogenase, and systolic blood pressure.
The Naive Bayes model maintained strong generalization in the external validation cohort with an AUC of 0.777.
Interpretation:
The Naive Bayes model may assist clinicians in early identification and personalized risk management of high-risk pregnancies, representing a step towards evidence-based decision support in obstetrics.
Limitations:
The study was limited to two centers and a relatively small sample size.
Further validation in larger, multicenter cohorts is needed.
Conclusion:
The Naive Bayes model is a promising tool for predicting preterm birth in high-risk pregnancies, warranting further research for real-time clinical application.
In a target-trial emulation of more than 600,000 veterans, GLP-1 RA initiators saw fewer new substance use disorders—and patients with existing SUDs had fewer overdoses, hospitalizations, and deaths.