Hypertensive Disorders in Pregnancy and Future Risk of Stroke: A Systematic Review (P2.114)
Bibliographic record
Abstract
OBJECTIVE: To assess whether women with a history of hypertension in pregnancy are more likely to experience stroke in later life compared to women with normotensive pregnancies. BACKGROUND: The role of hypertensive disorders in pregnancy in predicting future stroke risk remains be clearly elucidated. No specific recommendations have been made regarding stroke-related screening or preventative measures postpartum for these women. DESIGN/METHODS: For this systematic review, Medline and Pubmed were searched combining the MeSH terms “hypertension, pregnancy-induced”, “pre-eclampsia”,”eclampsia”, “HELLP syndrome”, or “toxemia” with the terms “Stroke” or “stroke, lacunar” using the AND modifier, while clinical trials registries and conference proceedings were similarly searched for unpublished studies. This generated 90 results in Medline and 172 results in Pubmed, of which 9 studies (2 prospective cohort, 4 retrospective cohort, 3 case-control) met inclusion criteria of involving women with hypertensive disorders in pregnancy; involving a prospective follow-up, retrospective review of records, or a case-control design; and reporting stroke as a clinical outcome. The inverse variance weighted method was used to obtain relative risks (RR) and 95% confidence intervals (CI), using random effects models for all analyses. RESULTS: There is consistent case-control and retrospective cohort evidence - international and multi-racial - of an increased risk of stroke in women with hypertensive disorders of pregnancy, in particular for those with pre-eclampsia/eclampsia, as demonstrated by both prospective cohort studies (RR 1.39 at 12 years for all-stroke). Pooling less heterogenous retrospective cohort and case-control data gave a RR of 2.26 (95% CI 1.39-3.69) for future stroke and 1.43 (95% CI 1.94-1.98) for future fatal stroke with a history of pre-eclampsia/eclampsia. There is weaker evidence of an increased incidence of stroke in later life with gestational hypertension alone. CONCLUSIONS: Hypertension in pregnancy likely carries an increased risk for stroke in later life, especially when associated with pre-eclampsia/eclampsia. There may be benefit in targeting these women for close risk-factor monitoring and control beyond the post-partum period.
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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 | 0.005 | 0.024 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.007 | 0.008 |
| Bibliometrics | 0.007 | 0.010 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.002 | 0.002 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.002 | 0.001 |
| Insufficient payload (model declined to judge) | 0.009 | 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".