Validity of Parent-Reported Gestational Age Categories and Association Between Total Gestational Weight Gain by Pre-pregnancy Body Mass Index and Moderate to Late Preterm Birth
Bibliographic record
Abstract
BACKGROUND: Gestational age is influenced by several factors; however, the impact of total gestational weight gain (GWG) on moderate to late preterm birth (32-<37 weeks) is less understood. OBJECTIVES: To evaluate the validity of parent-reported gestational age categories relative to administrative healthcare data. To evaluate the association between total GWG and moderate to late preterm birth. METHODS: Data analysis was conducted from children <6 years of age in the Toronto area enrolled in TARGet Kids!, a primary care-based pediatric research network. First, I conducted a validation study (n=4684) using linked data from TARGet Kids! and healthcare administrative data to assess the criterion validity of questionnaire-based parent-reported term (≥37 weeks), late preterm (34-36 weeks), and moderately preterm (32-33 weeks) birth. Second, I conducted a cross-sectional study (n=4529) using TARGet Kids! data to assess the association between total GWG and moderate to late preterm birth. GWG was categorized according to the Institute of Medicine (IOM) guidelines as inadequate, recommended, or excessive for each pre-pregnancy BMI category. Continuous GWG was also assessed. RESULTS: 97.3% correctly classified their child’s gestational age according to administrative data. Sensitivity was >80% and specificity was >85%. 31.1% of maternal parents had recommended GWG; 41.0% had excessive GWG and 27.9% had inadequate GWG. 8.2% of births were moderate to late preterm. Excessive GWG was strongly associated with moderate to late preterm birth (aOR 1.68; 95% CI 1.29, 2.19). For maternal parents with pre-pregnancy overweight or obesity, the risk of preterm birth did not increase substantially until well beyond the upper limit of the IOM guidelines. CONCLUSIONS: Parent-reported gestational age was accurate. The IOM total GWG recommendations may not align with the lowest risk of preterm birth for maternal parents with pre-pregnancy overweight or obesity. Future research should re-evaluate the recommendations, particularly among those with overweight or obesity pre-pregnancy.
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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 | 0.014 | 0.049 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.001 | 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 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".