P-763 Pregnancy complication in women with uterine fibroids (UFs) who conceived spontaneously or with IVF
Bibliographic record
Abstract
Abstract Study question Both IVF and UFs are risks for pregnancy complications however, does IVF increase complication in women with uterine fibroids, compared to those who conceived spontaneously? Summary answer Women with UFs who conceived with IVF when controlling for confounders had more hypertensive-disorders of pregnancy and gestational-diabetes, while risks of other complications were similar. What is known already Patients with UFs experience reduced fertility rates and increased obstetrical complications compared to patients without fibroids including preterm birth, PPROM, chorioamnionitis, placenta previa, placental abruption, postpartum hemorrhage, fetal malpresentation, intrauterine fetal demise, preeclampsia, eclampsia, chronic hypertension, gestational hypertension, pregnancy induced hypertension and caesarean section. IVF is a risk for hypertensive disorders of pregnancy, gestational diabetes, preterm delivery, caesarean section, post-partum hemorrhage, abnormal placentation, blood transfusion, maternal infection, hysterectomy, small for gestational age infants, intrauterine fetal demise and fetal congenital anomaly. A comparison of the effect of IVF on pregnancy complications in women with fibroids has not been undertaken. Study design, size, duration Retrospective cohort study, using the Healthcare Cost and Utilization Project Nationwide between 2008 until 2014, inclusively, based on International Classification of Diseases, 9 edition, diagnosis (ICD-9). Data was collected from 48 states and the District of Columbia, representing 20% of annual hospital admissions in the United States. Population-based study, including 590 patients with uterine fibroid who conceived with IVF and 60,283 controls with uterine fibroid who conceived spontaneously. Participants/materials, setting, methods Patients with uterine fibroids, female infertility, and treated with IVF (ICD-9 codes 218, 628.9, V26.82) and controls with uterine fibroid who conceived spontaneously. The data was compared using chi-squared tests and multivariate logistic regression was used and adjusted for age, race, income quartiles, smoking, previous caesarean section, chronic and pregnancy induced hypertension, obesity, multiple gestations, pregestational hypertension, gestational diabetes and thyroid disease. Data is expressed as OR and 95% confidence intervals (CI). Main results and the role of chance IVF women were significantly older, with more multiple gestations (27.5% vs. 2.7%; p < 0.0001), and more thyroid disease (15.1% vs. 4.9%; p < 0.0001). After adjustment IVF women had higher risks for pregnancy-induced hypertension (aOR:1.47, 95CI:1.19-1.82; p < 0.001), gestational hypertension (aOR:1.69, 95CI:1.23-2.32; p = 0.001), and gestational diabetes mellitus (aOR:1.41, 95%CI:1.12-1.77; p = 0.004). Although preeclampsia was more frequent in the IVF group (11.5% vs. 6.8%) it missed statistical significance (p = 0.07). There was no statistical differences between rates of wound complication (p = 0.71), placenta previa (p = 0.08), abruptio placenta (p = 0.33), preterm delivery (p = 0.81), Preterm premature rupture of membranes (p = 0.31), chorioamnionitis (p = 0.08), postpartum hemorrhage (p = 0.30), uterine rupture (p = 0.26), hysterectomy (p = 0.95), blood transfusions (p = 0.13), maternal infection (p = 0.08), vaginal delivery (p = 0.11), operative vaginal delivery (p = 0.83), spontaneous vaginal delivery(p = 0.11), small for gestational age infants (p = 0.59), IUFD (p = 0.34) and congenital anomalies (p = 0.48). Limitations, reasons for caution This is a retrospective study of a population database, with possibility for misclassification and other bias. There was a size discrepancy between groups. Wider implications of the findings Although IVF increase risks of GDM and hypertensive disorders of pregnancy possibly due to alternations in placentation, most expected complications induced by IVF use, including maternal and fetal did not occur, possibly influenced by the inherent increased risk already seen in the fibroid uterus. Borderline results should be further investigated. 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 | 0.000 | 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".