Risk factors for immediate postpartum sickle cell disease‐specific maternal morbidity
Bibliographic record
Abstract
Summary Pregnant individuals with sickle cell disease (SCD) are more likely to have postpartum complications. In this retrospective single‐centre study, 201 pregnancies from 145 individuals were assessed between 2000 and 2018 for the presence of a composite of immediate postpartum complications from admission during delivery to discharge, which included vaso‐occlusive pain events, acute chest syndrome, infection (blood, urine, pulmonary) and/or new‐onset hypoxia. Hypoxia was defined as SpO 2 below 92%. An immediate postpartum complication occurred in 74 pregnancies (37%), of which 97% experienced a vaso‐occlusive pain event. No immediate postpartum deaths were recorded. Pregnancies with HbSS/HbSβ0 as compared to HbSC/HbSβ+ had a higher incidence of the composite outcome (51% vs. 19%). On univariate analysis, HbSS/HbSβ0 genotype was associated with a higher likelihood of developing a postpartum complication (OR 4.49, 95%CI 2.35–8.57; p < 0.0001); however, this significance was reduced on multivariable analysis. The strongest risk factors associated with experiencing the composite outcome on multivariable analysis were hypoxia during pregnancy (OR 4.95, 95%CI 1.86–13.23; p = 0.001) and an unscheduled caesarean delivery (OR 2.67; 95%CI 1.26–5.64; p = 0.01). Future studies need to address whether correcting hypoxia and use of predictive scores to guide the need for a scheduled caesarean delivery can reduce immediate postpartum complication rates.
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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 | 0.000 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| 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".