{"id":58,"title":"Identification and dating of pregnancies in administrative healthcare claims databases: An updated, transparent, and transportable algorithm","title_zh":"行政医疗索赔数据库中妊娠识别与孕周推算：一个更新、透明且可跨库移植的算法","url":"https://pubmed.ncbi.nlm.nih.gov/42986179","doi":"10.1093/aje/kwag287","pmid":"42986179","journal":"Am J Epidemiol","kind":"paper","lang":"en","published_at":"2026-11-05T00:00:00+00:00","fetched_at":"2026-11-08T03:43:52+00:00","authors":["Makadia R","Voss EA","Swerdel J","Hardin J","Sarayani A","Krumme AA","Davis KJ","Ryan P","Jacobson MH"],"primary_topic":"early-pregnancy","topics":[{"slug":"ai-compute","score":4.0,"hits":["algorithm"]},{"slug":"early-pregnancy","score":2.0,"hits":["ectopic pregnancy","miscarriage"]},{"slug":"art-clinical","score":1.0,"hits":["live birth"]},{"slug":"contraception-health","score":1.0,"hits":["abortion"]}],"topic_score":4.0,"preference_score":0.0,"preference_labels":[],"llm_score":73.0,"final_score":73.0,"score_dims":{"novelty":62,"rigor":85,"impact":72,"relevance":56,"translation":62},"recommend_reason":"样本量巨大、跨三个数据库验证、算法透明可移植，是药物孕期安全与妊娠队列研究的重要方法学基础；但不涉及 ART 或胚胎实验室操作，与辅助生殖临床的直接关联有限。","keywords":["妊娠识别算法","行政索赔数据库","ICD-10-CM","药物流行病学","孕周推算","可重复性"],"selected":1,"story_id":60,"llm_provider":"deepseek","llm_model":"deepseek-flash","llm_effort":"low","source_key":"pubmed-art","source_name":"PubMed · 辅助生殖临床","source_tier":1,"mention_count":1,"has_interpretation":false,"journal_key":null,"journal_tier":"unknown","journal_if":null,"is_mock":false,"summary_zh":"该研究将既往开发的妊娠识别算法更新至 ICD-10-CM 编码体系，并转换为标准化格式以便跨数据库移植；随后在美国三个医保索赔数据库（2000–2025 年，覆盖商业保险与公共保险人群）中评估其实现特征。共识别出约 580 万、300 万（两个商业数据库）和 230 万（Medicaid 多州数据库）例妊娠。各库中活产占比 76–83%、流产/人工流产 15–23%、异位妊娠约 1%、死胎≤0.5%；Medicaid 库活产比例更高。孕周推算方式随编码时代显著变化：使用孕龄记录的比例从 ICD-9-CM 时代的 4–9% 升至 ICD-10-CM 时代的 87–92%。研究提示，数据库特征与编码转换会系统性影响妊娠识别与孕周推算，为可重复的妊娠药物流行病学研究提供方法学参考。","summary":"Studies using routinely collected healthcare data are essential for understanding the benefit-risk profile of medications in pregnancy. However, reproducibility is limited by the lack of shared pregnancy identification algorithms, and generalizability is constrained by their development primarily in commercial insurance databases. A previously developed pregnancy identification algorithm was updated for ICD-10-CM and translated into a standardized format to support transport across diverse databases. Algorithm implementation characteristics were evaluated in three US health insurance claims databases (2000-2025), including commercially and publicly insured populations. Overall, 5.8 million and 3.0 million pregnancies were identified in two commercial databases (Merative™ and Optum) and 2.3 million pregnancies in Merative™ MarketScan® Multi-State Medicaid Database (MDCD). Across databases, live birth prevalence ranged from 76-83%, miscarriage/abortion 15-23%, ectopic pregnancy 1%, and stillbirth ≤0.5%, with a higher proportion of live births in MDCD. Pregnancy dating methods varied substantially across coding eras: use of gestational age records increased from 4-9% in the ICD-9-CM era to 87-92% during the ICD-10-CM era, with greater use in MDCD. Using a standardized algorithm, this study demonstrates how database characteristics and coding transitions influence pregnancy identification and dating in healthcare data, highlighting methodological considerations for reproducible pregnancy research across data sources.","interpretation_basis":null,"fulltext_status":null,"interpretation":null,"fulltext":{"available":false,"status":null,"reason":"尚未抓取全文（未入选、分数未达阈值，或还没跑 fulltext 步骤）","pmcid":null,"license":null,"chars":0,"source":null,"fetched_at":null}}