Obstetrical Clostridium difficile Infection: A Retrospective Cohort Study [30D]
Bibliographic record
Abstract
INTRODUCTION: Clostridium difficile infections (CDIs) occurring in pregnancy and the peripartum period have been reported with increasing frequency. The aim of this study was to evaluate the risk factors and morbidity associated with obstetrical CDI. METHODS: We performed a retrospective cohort study, using the Healthcare Cost and Utilization Project Nationwide Inpatient Sample. The admission and delivery records of pregnant women were reviewed between 1999 and 2013. After adjusting for demographic data, the antenatal admission record and delivery outcomes of women with CDI in pregnancy were compared to pregnancies without CDI, using unconditional logistic regression. RESULTS: Of the total 12,592,178 births in our cohort, we identified 2757 admissions complicated by CDI. During the study period, the rate of antenatal admission for CDI doubled from 15 to 30 admissions per 100 000 deliveries per year (p < 0.001). Risk factors associated with CDI in pregnancy include: age over 35, multiple gestations, smoking, Crohn’s disease, ulcerative colitis, long-term antibiotic use, pneumonia, pyelonephritis, as well as cesarean or perineal wound infection. CDI in pregnancy was associated with a significant increase in maternal death (OR 56.82, 95% CI 35.83-90.10). Further, there was an increase in sepsis (OR 59.10, 95% CI 48.80-71.57), paralytic ileus (OR 33.08, 95% CI 27.51-39.78), venous thromboembolism (OR 8.14, 95% CI 6.52-10.16) and hospital stays greater than 2 weeks (OR 24.34, 95% CI 21.59-27.44). CONCLUSION: CDIs in pregnancy have increased over the last fifteen-years and are associated with significant maternal morbidity and increased mortality.
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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 | 0.004 |
| Meta-epidemiology (narrow) | 0.000 | 0.001 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.001 | 0.003 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.001 | 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".