P-620 Polycystic Ovary Syndrome and Severe Maternal Morbidity: A Population-Based Cohort Study
Notice bibliographique
Résumé
Abstract Study question Is polycystic ovary syndrome (PCOS) associated with an increased risk of severe maternal morbidity (SMM)? Summary answer PCOS is modestly associated with an increased risk of SMM, independent of the use of fertility treatments What is known already Women with PCOS are at greater risk for pregnancy complications, including hypertensive disorders and gestational diabetes. Metabolic disorders that are part of PCOS, including obesity and chronic hypertension, are known risk factors for adverse pregnancy outcomes. However, data are lacking on the association between PCOS and SMM -- a composite measure reflective of prolonged hospital length of stay and maternal mortality. Study design, size, duration This population-based cohort study analyzed all births in Ontario, Canada, between October 2006 and February 2021. The exposure was a validated algorithm that identifies PCOS, based on a physician diagnostic billing code for PCOS (ICD-9 256) or hirsutism (ICD-9 709), in conjunction with irregular menses (ICD-9 626). The primary outcome was a validated composite outcome of SMM arising during pregnancy or up to 42 days thereafter. Participants/materials, setting, methods Linked administrative datasets were used to capture hospital births in Ontario, maternal health and pregnancy characteristics, and use of fertility treatment. Modified Poisson regression generated adjusted relative risks (aRR), comparing women with vs. without PCOS. Models were further stratified by pregnancy characteristics and mode of conception: (i) unassisted conception, (ii) diagnosed infertility (ICD-9 628) without fertility treatment, (iii) ovulation induction or intrauterine insemination (OI/IUI), and (iv) in vitro fertilization or intracytoplasmic sperm injection (IVF/ICSI). Main results and the role of chance 492,147 pregnancies had an antecedent diagnosis of PCOS and 1,104,081 did not. Median (IQR) time from PCOS diagnosis to index pregnancy was 13 (9-16) y. Women with PCOS were older (32.1 vs. 29.9 y) and were more obese (23.8% vs. 18.7%). Women with vs. without PCOS had a slightly higher rate of SMM (2.4 vs. 2.2 per 100 births) – an adjusted RR of 1.06 (95% CI 1.03-1.08) overall. The aRR for SMM in women with PCOS and chronic hypertension was 1.23 (95% CI 1.10-1.37). SMM rates varied by mode of conception. PCOS was associated with a slightly increased aRR of SMM in women with unassisted conception (1.03, 95% CI 1.01-1.06), and those with infertility without fertility treatment (1.11, 95% CI 1.05-1.17), but not those receiving OI/IUI (1.13, 95% CI 0.97-1.32) or IVF/ICSI (1.00, 95% CI 0.90-1.12). Limitations, reasons for caution The study’s retrospective design and reliance on linked health administrative databases may introduce outcome misclassification and residual confounding. Wider implications of the findings PCOS may modestly increase the risk of SMM, independent of fertility treatment. Awareness of this association can aid clinicians in risk stratification and management. Trial registration number No
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,001 | 0,003 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,001 |
| Méta-épidémiologie (sens large) | 0,000 | 0,001 |
| Bibliométrie | 0,001 | 0,003 |
| Études des sciences et des technologies | 0,001 | 0,000 |
| Communication savante | 0,001 | 0,000 |
| Science ouverte | 0,001 | 0,001 |
| Intégrité de la recherche | 0,001 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,003 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».