Incidence and Outcomes of Surgically Managed Ectopic Pregnancy in Women With Disabilities: A Population‐Based Cross‐Sectional Study
Bibliographic record
Abstract
BACKGROUND: Disparities in the incidence, management, and outcomes of ectopic pregnancy have been documented among marginalised patients; however, there are few data on ectopic pregnancy in women with disabilities. OBJECTIVE: To compare the incidence and outcomes of surgically managed ectopic pregnancy in women with and without disability. METHODS: We conducted a population-based cross-sectional study using the National Inpatient Sample of discharges from US community hospitals (January 2016-December 2021). We analysed 9769 hospitalisations for surgically managed ectopic pregnancy among females aged 15-44 years. Disability was measured using a published administrative data diagnosis code algorithm. Outcomes were the incidence rate of ectopic pregnancy, surgical management approach (route, tubal removal versus sparing), complications (length of stay [LOS] ≥ 3 days, blood transfusion), and use of more extensive procedures than are standard (hysterectomy, oophorectomy, bilateral salpingectomy, tubal ligation). Weighted analyses were used to generate unadjusted incidence rate ratios (IRR) and outcome risk ratios (RR) from modified Poisson regression adjusted for year of surgery, socio-demographics, smoking, and comorbidities. RESULTS: The rate of surgically managed ectopic pregnancy was 2.8 per 1000 obstetric deliveries in disabled females and 2.3 per 1000 in non-disabled females (IRR 1.26, 95% CI 1.08, 1.45). Compared to non-disabled females, disabled females more often experienced prolonged LOS (adjusted RR 1.34, 95% CI 1.03, 1.74) and use of extensive procedures (adjusted RR 1.49, 95% CI 1.11, 2.00), including hysterectomy (adjusted RR 1.75, 95% CI 0.91, 3.36), oophorectomy (adjusted RR 1.43, 95% CI 0.96, 2.13), and bilateral salpingectomy (adjusted RR 1.30, 95% CI 0.71, 2.37); however, some estimates were imprecise due to low cell counts. CONCLUSIONS: Disabled women faced slightly higher rates of surgically managed ectopic pregnancy and use of more extensive surgical procedures, including sterilisation. Targeted patient education on ectopic pregnancy and equity-focused guidance for surgeons may be beneficial.
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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 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 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 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, 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".