P-620 Polycystic Ovary Syndrome and Severe Maternal Morbidity: A Population-Based Cohort Study
Bibliographic record
Abstract
Abstract Study question Is polycystic ovary syndrome (PCOS) associated with an increased risk of severe maternal morbidity (SMM)? Summary answer PCOS is modestly associated with an increased risk of SMM, independent of the use of fertility treatments What is known already Women with PCOS are at greater risk for pregnancy complications, including hypertensive disorders and gestational diabetes. Metabolic disorders that are part of PCOS, including obesity and chronic hypertension, are known risk factors for adverse pregnancy outcomes. However, data are lacking on the association between PCOS and SMM -- a composite measure reflective of prolonged hospital length of stay and maternal mortality. Study design, size, duration This population-based cohort study analyzed all births in Ontario, Canada, between October 2006 and February 2021. The exposure was a validated algorithm that identifies PCOS, based on a physician diagnostic billing code for PCOS (ICD-9 256) or hirsutism (ICD-9 709), in conjunction with irregular menses (ICD-9 626). The primary outcome was a validated composite outcome of SMM arising during pregnancy or up to 42 days thereafter. Participants/materials, setting, methods Linked administrative datasets were used to capture hospital births in Ontario, maternal health and pregnancy characteristics, and use of fertility treatment. Modified Poisson regression generated adjusted relative risks (aRR), comparing women with vs. without PCOS. Models were further stratified by pregnancy characteristics and mode of conception: (i) unassisted conception, (ii) diagnosed infertility (ICD-9 628) without fertility treatment, (iii) ovulation induction or intrauterine insemination (OI/IUI), and (iv) in vitro fertilization or intracytoplasmic sperm injection (IVF/ICSI). Main results and the role of chance 492,147 pregnancies had an antecedent diagnosis of PCOS and 1,104,081 did not. Median (IQR) time from PCOS diagnosis to index pregnancy was 13 (9-16) y. Women with PCOS were older (32.1 vs. 29.9 y) and were more obese (23.8% vs. 18.7%). Women with vs. without PCOS had a slightly higher rate of SMM (2.4 vs. 2.2 per 100 births) – an adjusted RR of 1.06 (95% CI 1.03-1.08) overall. The aRR for SMM in women with PCOS and chronic hypertension was 1.23 (95% CI 1.10-1.37). SMM rates varied by mode of conception. PCOS was associated with a slightly increased aRR of SMM in women with unassisted conception (1.03, 95% CI 1.01-1.06), and those with infertility without fertility treatment (1.11, 95% CI 1.05-1.17), but not those receiving OI/IUI (1.13, 95% CI 0.97-1.32) or IVF/ICSI (1.00, 95% CI 0.90-1.12). Limitations, reasons for caution The study’s retrospective design and reliance on linked health administrative databases may introduce outcome misclassification and residual confounding. Wider implications of the findings PCOS may modestly increase the risk of SMM, independent of fertility treatment. Awareness of this association can aid clinicians in risk stratification and management. Trial registration number No
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.000 |
| 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) | 0.000 | 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 teacher head, 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".