Effects of fetal reduction in multi-fetal pregnancy on perinatal outcomes
Bibliographic record
Abstract
ABSTRACTBackgroundThere is currently insufficient evidence regarding the prognosis of multi-fetal pregnancies reduced to twins or singletons. We compared the perinatal outcomes of deliveries following fetal reduction with the perinatal outcomes of deliveries without fetal reduction. MethodsWe carried out a retrospective cohort study of all births in British Columbia between 2009 and 2013, using information from a population-based database. Comparisons were made between all women who had a fetal reduction to a twin or a singleton pregnancy with those who did not undergo a fetal reduction procedure. The outcomes of interest were preterm delivery and composite severe neonatal morbidity or perinatal mortality. Generalized estimating equations adjusting for maternal age, parity, pre-pregnancy weight, use of in vitro fertilization and baby’s sex were used to estimate odds ratios (OR) and 95% confidence intervals (CI). ResultsAmong 207,273 deliveries, 139 (0.07%) had a fetal reduction. Of these, 89 women delivered twins and 50 delivered singletons. Women who had a fetal reduction were more likely to have conceived with in vitro fertilization (77.6%) compared with those who did not (3.31%). Twins delivered after fetal reduction had lower rates of neonatal morbidity/mortality (OR 0.19, 95% CI 0.08-0.42) compared with unreduced triplets but rates similar to those of twins without a reduction procedure (OR 1.44, 95% CI 0.81-2.58). Singletons delivered after fetal reduction had non-significantly lower rates of neonatal morbidity/mortality than unreduced twins (OR 0.75, 95% CI 0.36-1.57) but significantly higher rates of neonatal morbidity/mortality (OR 3.98, 95% CI 1.91-8.30), preterm delivery and being small for gestational age than singleton pregnancies without a reduction procedure. ConclusionPerinatal outcomes of twins delivered after fetal reduction are better than those of unreduced triplets and similar to those of unreduced twins.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.012 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.002 | 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 source (direct Gemma or distilled Codex), 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".