Does having cesarean section capability make a difference to a small rural maternity service?
Bibliographic record
Abstract
OBJECTIVE: To determine whether having cesarean section capability in an isolated rural community makes a difference in adverse maternal or perinatal outcomes. DESIGN: Retrospective study comparing population-based obstetric outcomes of two rural remote hospitals in northwestern British Columbia. One hospital had cesarean section capability; one did not. SETTING: Bella Coola General Hospital (with cesarean section capability) in Bella Coola Valley (BCV) and Queen Charlotte Islands General Hospital (without cesarean section capability) in Queen Charlotte City (QCC). PARTICIPANTS: Women who carried pregnancies beyond 20 weeks' gestation and who gave birth between January 1, 1986, and December 31, 2000. INTERVENTIONS: British Columbia Vital Statistics Agency data was used to compare obstetric outcomes in the two communities. A chart audit of local births at BCV and QCC was done to validate the vital statistics data. MAIN OUTCOME MEASURES: Perinatal death, newborn transfer to a tertiary care facility, birth weight, gestational age at delivery, mode of delivery, and Apgar score. RESULTS: The rate of preterm deliveries in QCC was higher (relative risk 1.41, 95% confidence interval 1.00 to 1.99; P = .047) than the rate in BCV. Otherwise, there were no differences in adverse maternal or perinatal outcomes in the two populations. In BCV, 69.8% of women delivered locally compared with 50.2% of women in the southern Queen Charlotte Islands (P < .001). CONCLUSION: Having local cesarean section capability is associated with a greater proportion of local deliveries and a lower rate of preterm deliveries.
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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 | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| 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".