P-754 Obstetric and neonatal outcomes in obese patients undergoing in vitro fertilization: a population-based study of more than 300,000 women
Bibliographic record
Abstract
Abstract Study question What is the role of in-vitro fertilization (IVF) on obstetric and neonatal risks among obese women compared to natural conception? Summary answer IVF amplifies the risk of obstetric and neonatal complications, including gestational diabetes (GDM), caesarean delivery (CS), small-for-gestational-age (SGA) and congenital anomalies. What is known already Both obesity and IVF independently increase the risk of adverse pregnancy outcomes. However, data on their combined impact remain limited, particularly in large populations. Study design, size, duration A retrospective cohort study of 322,171 obese women who delivered in the United States between 2004 and 2014 using the HCUP-NIS database. Participants/materials, setting, methods The study included obese women with ICD-9 codes for IVF (561 cases) compared to those without IVF (321,610 controls). Multivariate logistic regression was used to adjust for potential confounders and evaluate the impact of IVF on obstetric and neonatal outcomes. Main results and the role of chance After adjustment, IVF was associated with increased risks of GDM (aOR 1.36, 95% CI 1.13–1.65), placenta previa (aOR 2.29, 95% CI 1.17–4.47), CS (aOR 1.71, 95% CI 1.40–2.09), preterm premature rupture of membranes (PPROM) (aOR 1.55, 95% CI 1.04–2.32), chorioamnionitis (aOR 1.80, 95% CI 1.19–2.73), maternal infection (aOR 1.64, 95% CI 1.10–2.45), and postpartum hemorrhage (PPH) (aOR 1.60, 95% CI 1.14–2.23). Neonatal risks included SGA (aOR 1.80, 95% CI 1.27–2.54) and congenital anomalies (aOR 2.11, 95% CI 1.12–3.99). Similar outcomes between the two groups included rates of hypertensive disorders of pregnancy, placental abruption, preterm delivery (PTD), operative vaginal delivery (OVD), wound complications, transfusion, hysterectomy, thromboembolic events, maternal death, and intrauterine fetal demise (IUFD) (adjusted p-value > 0.05 for all). Limitations, reasons for caution As a retrospective analysis, causality cannot be inferred. Unmeasured confounders may impact results despite robust statistical adjustments. Wider implications of the findings These findings highlight the need for tailored care and close monitoring of obese women undergoing IVF to mitigate these increased obstetric and neonatal risks. Trial registration number No
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How this classification was reachedexpand
Direct model labels (unvalidated)
Per-model category and study-design labels from the labeling rounds. They are machine output, unvalidated, and the disagreement between models ships as data. No study design here is MEDLINE-validated yet.
| Model arm | Categories | Study design | Confidence |
|---|---|---|---|
| gemma | no category Domain: not available · Genre: Empirical About the Canadian research system: no · About a Canadian topic: no | Observational | low |
| gpt | no category Domain: not available · Genre: Empirical About the Canadian research system: no · About a Canadian topic: no | Observational | high |
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 | 0.003 |
| Meta-epidemiology (narrow) | 0.000 | 0.001 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.001 | 0.002 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.000 | 0.001 |
| 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, unvalidatedLabeled directly by 2 models reading the full record.
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".