Induction of Labor at 38 Weeks and Risk of Cesarean Delivery Among Obese Women: A Retrospective Propensity Match Study [21D]
Bibliographic record
Abstract
INTRODUCTION: The objective of this study was to determine if induction of labor (IOL) in obese women at 38 weeks decreases the risk of cesarean delivery (CD) compared to women who are expectantly managed. METHODS: We conducted a retrospective propensity match study using the CDC's Period Linked Birth-Infant Death data. The study population included all singleton, nonanomalous and cephalic births to obese women as of 38 weeks that occurred between 2013 and 2017, inclusively. Women who had a previous CD were excluded. The women who underwent IOL at 38 weeks were propensity matched to women, on the basis of CD risk factors, who were expectantly managed. Conditional logistic regression models were used to compare CD rates and maternal outcomes between obese women undergoing an IOL at 38 weeks and those expectantly managed. RESULTS: After 1:5 propensity score matching, there were 117,136 obese women induced at 38 weeks and 585,680 obese women expectantly managed. Overall, the risk of CD among obese women who had an IOL at 38 weeks was lower than those of women managed expectantly, 0.76 (0.75–0.77). The decrease in the risk of CD was more significant in multiparas, 0.62 (0.61–0.64), compared to nulliparas, 0.96 (0.94–0.99). When stratified by BMI, the effect of IOL on CD was most pronounced in women with a BMI >40 kg/m2, 0.74 (0.71–0.77). Maternal outcomes were comparable in both groups. CONCLUSION: Induction of labor at 38 among obese women appears to lower the risk of CD without compromising maternal outcomes.
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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 | 0.005 |
| 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 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| 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".