OP30.01: The perinatal risks of twin pregnancy in women over the age of 40
Bibliographic record
Abstract
The proportion of women who delay childbearing beyond the age of 40 years is increasing. The purpose of this study is to describe the perinatal outcomes in women delivering twins after the age of 40. A retrospective cohort study. Women were included if they were ≥ 40 years, delivering twins after 20 weeks' gestation. Maternal medical complications, preterm birth, birthweight < 10th percentile, and obstetric complications were compared with a control group of twin pregnancies among women aged 20–30 at delivery. Between 2005–2011, 124 pregnancies met inclusion criteria, with a median maternal age 41. These were compared to 124 randomly selected controls, median maternal age 28. Significantly more women > 40 conceived using ART (P < 0.001). Maternal complications were increased in women > 40, with an increased composite of hypertension and diabetes (OR 2.34, 95% CI 1.32–4.13), and increased likelihood of delivery by caesarean section (OR 2.72, 95% CI 1.53–4.82). Preterm birth (< 37 weeks) was less likely among women > 40 (OR 0.45, 95% CI 0.26–0.78), however, significantly more infants had birthweight < 10th percentile (OR 2.28, 95% CI 1.40–3.72). Adjusting for chorionicity, mode of conception, and prior medical disease, this risk remained increased (AOR 2.63, 95% CI 1.48–4.67). Twin pregnancy in women ≥ 40 years of age is associated with increased maternal and neonatal risks. There is a decreased risk of prematurity amongst older women delivering twins, however with longer gestation comes an increased risk of growth restriction. This information should be available to women considering multiple embryo transfer IVF after the age of 40. Furthermore, care providers should be aware that twin pregnancies in this age group require increased maternal and fetal surveillance, in order to ensure optimal maternal and perinatal outcomes.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.018 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".