The Effect of Planned Mode of Delivery in Morbidly Obese Women [29J]
Bibliographic record
Abstract
INTRODUCTION: Morbidly obese women have a higher risk of experiencing adverse pregnancy outcomes. The aim of this study is to determine which planned mode of delivery, elective cesarean section versus vaginal delivery, presents better maternal outcomes in morbidly obese women. METHODS: We conducted a population-based, retrospective cohort study using the United States' Health Care Cost and Utilization Project's Nationwide Inpatient Sample to evaluate maternal outcomes in morbidly obese women without comorbidities delivering between 2000 and 2014. Multivariate logistic regression was used to compare outcomes in morbidly obese women according to mode of delivery. RESULTS: We identified a total of 77,666 deliveries in otherwise healthy morbidly obese women. The planned cesarean group comprised 13.4% of the cohort. When compared to women in the planned vaginal group, the planned cesarean group was at higher risk for transfusion (OR 1.48 [95% CI 1.23–1.77]), chorioamnionitis (OR 1.61 [1.44–1.81]) and major puerperal infection (OR 1.28 [1.05–1.56]). Women in the planned cesarean group had a lower risk of postpartum cardiomyopathy (OR 0.07 [0.02–0.22]), amniotic fluid embolism (OR 0.08 [0.02–0.31]), deep vein thromboembolism (OR 0.25 [0.08–0.79]), sepsis (OR 0.18 [0.07–0.44]) and wound dehiscence (OR 0.36 [0.23–0.59]). These reduced risks in the latter are partly due to the high rate of cesarean among planned vaginal deliveries in which morbidities appeared highest. CONCLUSION: Emergency cesarean section presents higher risks compared to planned cesarean section. Given that many planning a vaginal delivery will undergo emergency cesarean section, morbidly obese women should be informed of the high rate of failed vaginal delivery and subsequent risks.
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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 | 0.006 |
| 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 | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.003 | 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".