P-305 Are there compensatory mechanisms in place to improve certain pregnancy complications in Black women with fibroid uteri? A study of more than 50,000 women
Bibliographic record
Abstract
Abstract Study question Given how common uterine fibroids are in a black population we pondered if mechanisms were in place to decrease pregnancy complications? Summary answer Black women with fibroids had lower risks of gestational-diabetes, cesarean-sections and infants with congenital anomalies. Caucasians experienced lower rates of hypertensive-disorders, infections, among other complications. What is known already Black women have increased rates of most pregnancy complications when compared to white women in the USA, including risks of cesarean section, gestational diabetes, hypertensive disorders, post-partum hemorrhage, and transfusions, despite controlling for confounding effects including income, health status and illicit drug use. Uterine fibroids increase many pregnancies complication and are more common in Black women than Caucasians with a two to threefold increased risk. Study design, size, duration This retrospective population-based cohort study utilized data from the Healthcare-Cost and Utilization Project-Nationwide Inpatient Sample (HCUP-NIS) from 2010 to 2014, inclusively. There were 53340 pregnant women with uterine fibroids, 28,893 White and 24,447 Black, who underwent a delivery or maternal death. Participants/materials, setting, methods HCUP-NIS is the largest inpatient database in the USA and provides information relating to seven-million inpatient stays yearly, includes 20% of admissions, and represents over 96% of Americans. Multivariate logistic regression was conducted to explore associations between fibroids and Pregnancy outcomes delivery outcomes and Neonatal outcomes,while controlling for confounding effects. According to the Tri-Council Policy Statement (2018), IRB approval was not required, given data was anonymous and publicly available. Main results and the role of chance Significant differences were observed in maternal characteristics including age-distribution, and income-quartiles-(p < 0.0001, all). Black women had higher rates of Medicaid, chronic-hypertension, obesity, pregestational -diabetes, illicit-drug use, tobacco-smoking, and HIV-(p < 0.0001, all). White women had higher cesarean section rates-(aOR:1.36, 95%CI:1.29-1.43, p < 0.0001) and lower risks of spontaneous vaginal deliveries-(aOR:0.72, 95%CI:0.69-0.77, p = 0.72), white women had also higher gestational diabetes-(aOR:1.10, 95%CI:1.03-1.19, p = 0.008), gestational hypertension-(aOR:1.12, 95%CI:1.01-1.23, p = 0.024) and higher congenital anomalies in white neonate-(aOR:2.78, 95%:2.21-3.49, p = 0.0001), when compared to Blacks. White women showed lower odds of: pregnancy-induced hypertension-(aOR:0.92, 95%CI:0.86-0.97, p = 0.005), preeclampsia-(aOR:0.86, 95%CI:0.79-0.94, p < 0.0001), eclampsia-(aOR:0.45, 95%CI: 0.22-0.93 p = 0.031), preeclampsia and eclampsia superimposed hypertension-(aOR:0.75, 95%CI:0.65-0.088, p < 0.0001), premature preterm rupture of membrane-(aOR:0.76, 95%CI:0.65-0.89, p < 0.001), preterm delivery-(aOR:0.68, 95%CI:0.63-0.73, p < 0.0001), chorioamnionitis-(aOR:0.85, 95%CI:0.74-0.98, p = 0.020), spontaneous vaginal deliveries-(aOR:0.72, 95%CI:0.69-0.77, p = 0.72), postpartum hemorrhage-(aOR:0.82, 95%CI:0.74-0.92, p = 0.001), blood transfusions-(aOR:0.49, 95%CI:0.43-0.57, p < 0.0001), maternal infections-(aOR:0.76, 95%CI:0.67-0.85, p = 0.0001) & small for gestational age neonates-(aOR:0.70, 95%CI:0.63-0.77, p < 0.0001), than Blacks. No significant differences were found in placenta previa-(aOR1.15, 95%CI:0.98-1.36, p = 0.094), abruptio placenta-(aOR:0.89, 95%CI:0.76-1.03, p = 0.126), operative vaginal delivery-(aOR:1.01, 95%CI:0.92-1.10, p = 0.906), Hysterectomy-(aOR:0.89, 95%CI:0.66-1.21, p = 0.450), wound complications-(aOR:1.06, 95%CI:0.85-1.32, p = 0.602), maternal deaths-(aOR:0.00, p = 0.959), DVT-(aOR:0.81, 95%CI:0.41-1.61, p = 0.552), pulmonary embolism-(aOR:0.64, 95%CI:0.19-1.13, p = 0.91), VTE-(aOR:0.67, 95%CI:0.93-1.53, p = 0.148), DIC-(aOR:0.92, 95%CI:0.68-1.26, p = 0.614), and intrauterine fetal death-(aOR:0.79, 95%CI:0.57-1.09, p = 0.153). Limitations, reasons for caution The limitations of our study are related to its retrospective nature and use of administrative database, which relies on the accuracy, and consistency of the individual coding the data. Wider implications of the findings Health-disparities exist when comparing black and white women with fibroids in pregnancy. However, the uteri of black women seem more tolerant as related to arrested labor and the need for cesarean sections and fetii with congenital anomalies. The mechanism lowering risks of GDM in black women with fibroids needs study. Trial registration number No
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
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 | 0.000 | 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".