Using AMANHI-ACT cohorts for external validation of Iowa new-born metabolic profiles based models for postnatal gestational age estimation

• DOI: 10.7189/jogh.11.04044
• Publication Date: 2021-07-17T10:12:33Z
• Authors: Sunil Sazawal; Kelli K Ryckman; Harshita Mittal; Rasheda Khanam; Imran Nisar; Elizabeth Jasper; Sayedur Rahman; Usma Mehmood; Sayan Das; Bruce Bedell; Nabidul Haque Cho...; Amina Barkat; Arup Dutta; Saikat Deb; Salahuddin Ahmed; Farah Khalid; Rubhana Raqib; Muhammad Ilyas; Ambreen Nizar; Said Mohammed Ali; Alexander Manu; Sachiyo Yoshida; Abdullah H Baqui; Fyezah Jehan; Usha Dhingra; Rajiv Bahl
• Keywords: Youden's J statistic; Gold standard (test)

Globally, 15 million infants are born preterm and another 23.2 small for gestational age (SGA). Determining burden of SGA births, is essential effective planning, modification health policies targeting interventions reducing these outcomes which accurate estimation (GA) crucial. Early pregnancy ultrasound measurements, last menstrual period post-natal neonatal examinations have proven to be not feasible or inaccurate. Proposed algorithms GA in western populations, based on routine new-born screening, though promising, lack validation developing country settings. We evaluated the hypothesis that models developed USA, also predicted cohorts South Asia (575) Sub-Saharan Africa (736) with same precision.Dried heel prick blood spots collected 24-72 hours after birth from 1311 new-borns, were analysed standard metabolic screen. Regression algorithm based, estimates computed data compared first trimester validated, (gold standard).Overall Algorithm (metabolites + birthweight) estimated within an average deviation 1.5 weeks. The was gold estimate by 1 2 weeks 70.5% 90.1% new-borns respectively. Inclusion birthweight metabolites model improved discriminatory ability this method, showed promise identifying births. Receiver operating characteristic (ROC) curve analysis area under 0.86 (conservative bootstrap 95% confidence interval (CI) = 0.83 0.89); P < 0.001) Youden Index 0.58 (95% CI 0.51 0.64) a corresponding sensitivity 80.7% specificity 77.6%.Metabolic dating offers novel means population-level LMIC settings help surveillance initiatives. Further research should focus use machine learning newer analytic methods broader than conventional screen analytes, enabling incorporation region-specific analytes cord profiles predicting accurately.