Birth rates after laparoscopic and open ileal pouch–anal anastomosis for ulcerative colitis: a nationwide population-based cohort study
Bibliographic record
Abstract
Dear Editor, Women who undergo restorative surgery with open ileal pouch–anal anastomosis (IPAA) for ulcerative colitis (UC) have reduced fecundity compared to UC women without IPAA1. A laparoscopic approach has been increasingly used in recent times. Small observational studies have suggested that a laparoscopic approach is associated with a less detrimental impact on fecundity than open surgery2–4, possibly because of fewer pelvic adhesions. However, this presumed benefit of laparoscopy on fecundity rates is based on imprecise and potentially biased estimates from four observational studies2–5. The aim of this study was to examine birth rates and other measures of fertility in women of childbearing age having undergone laparoscopic or open IPAA surgery for UC. All women aged 15–50 undergoing IPAA for UC in Denmark in the period 2000–2022 were identified from the Danish National Patient Registry (see Appendix for diagnostic and surgical codes). Women with a procedure code for hysterectomy or sterilization prior to IPAA were excluded. For patients with a procedure code for ileostomy reversal within 6 months after IPAA, the date of reversal was defined as the date of bowel restoration. If no procedure code for ileostomy reversal was registered in the first 6 months after IPAA, the index IPAA procedure was defined as non-diverted and the date of bowel restoration was defined as the date of IPAA.
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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 | 0.001 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.003 | 0.001 |
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".