OP11.03: Visceral adiposity in early pregnancy and the risk of pre‐eclampsia and preterm birth
Bibliographic record
Abstract
The risk of both pre-eclampsia and preterm delivery is linearly related to pre-pregnancy body mass index (BMI). BMI though, does not distinguish between excess fat, muscle, or bone mass, nor does it reveal the distribution of adipose tissue. Visceral adipose tissue (VAT) may better reflect cardiometabolic risk than BMI. Our objective was to identify the independent contribution of maternal VAT in early pregnancy to the risk of developing pre-eclampsia, preterm birth or both. We completed a prospective cohort study at St. Michael's Hospital in Toronto, Ontario, a large urban hospital between 2012 and 2014. We included women with a viable singleton pregnancy and no known diabetes mellitus within or outside of pregnancy. At 11–14 weeks' gestation, at the time of sonographic assessment of fetal nuchal translucency, maternal VAT depth was determined using a validated and standardised method. VAT depth was measured in triplicate, and then averaged. We examined the relation between VAT depth quintile and the subsequent development of i) pre-eclampsia ii) preterm birth before 37 weeks gestation; or iii) pre-eclampsia with preterm birth before 37 weeks. Relative risks (RR) were generated using modified Poisson regression adjusted for maternal age, parity, history of chronic hypertension, pre-pregnancy BMI and aspirin use in pregnancy. A total of 463 women were available for full analysis. The mean (SD) age was 32.9 (4.7) years, and mean (SD) BMI was 24.0 (4.9) kg/m2. The rate of pre-eclampsia was higher at Q5 of VAT depth (9.8%) than at Q1-4 (1.6%), equivalent to an aRR of 3.4 (95% CI 0.86 to 13.4). The risk of preterm birth was significantly elevated at Q5 VAT depth, as was the risk of pre-eclampsia with preterm birth (aRR 16.9, 95% CI 1.2 to 231.1). Increased maternal visceral adiposity in the first trimester of pregnancy is a risk factor for pre-eclampsia and preterm birth independent of maternal BMI. We postulate that inflammatory and angiogenic factors produced by the visceral adipose compartment play a role in this association.
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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 | 0.001 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.004 | 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".