Bibliographic record
Abstract
Background: Obese and overweight women are frequent users of in-vitro fertilization (IVF) owing to the association between increased body mass index (BMI) and infertility. Policies that impose BMI restrictions for access to IVF exist in some countries, based on limited evidence suggesting that obese women experience reduced IVF success rates. However, there is a paucity of data on the frequency and risk of preeclampsia in the obese IVF population. More data would help inform such policies. Objectives: (i) To evaluate the respective effects of an elevated BMI (> 25 kg/m2) and the use of IVF on the risk of preeclampsia; (ii) to assess whether the risk of preeclampsia associated with an elevated BMI is different between twins and singletons; and (iii) to assess whether the effect of elevated BMI is modified by IVF treatment. Methods: The study population originated from a cohort of births delivered at the Royal Victoria Hospital in Montreal, Canada recorded between 2001 and 2008 in the McGill Obstetric and Neonatal Database (MOND). Associations were investigated with descriptive statistics, univariate and multivariate logistic regressions. We assessed effect modification by comparing observed to expected combined effects of a raised BMI and IVF treatment on preeclampsia. Results: Preeclampsia complicated 4.4% of pregnancies. There was an increased risk of preeclampsia among overweight and obese mothers (adjusted OR 3.1, 95% CI 2.5, 3.7). IVF treatment did not confer a heightened risk of preeclampsia in multivariate analyses (adjusted OR 1.0, 95% CI 0.7, 1.5). There was heterogeneity of the effect of BMI in singletons vs. multiples. There was evidence for synergism between IVF and obesity among singletons. Conclusions: Our study confirms the strong association between high BMI and preeclampsia. Despite a null effect of IVF on its own, obese women with singleton pregnancies who use IVF have a higher relative and absolute risk of preeclampsia than spontaneous singleton pregnancies. Given that preeclampsia is a serious complication of pregnancy, its risk should be considered in policy decisions about access to IVF treatment in the overweight and obese population.
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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 | 0.004 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| 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".