Fetal exposure to ACE inhibitors increased risk of major congenital malformations
Bibliographic record
Abstract
Cooper WO, Hernandez-Diaz S, Arbogast PG, et al. Major congenital malformations after first-trimester exposure to ACE inhibitors. N Engl J Med 2006;354:2443–51. [OpenUrl][1][CrossRef][2][PubMed][3][Web of Science][4] Q Is fetal exposure to angiotensin converting enzyme (ACE) inhibitors during the first trimester of pregnancy associated with increased risk of congenital malformations? Clinical impact ratings GP/FP/Primary care ★★★★★★☆ Cardiology ★★★★★★☆ Obstetrics ★★★★★★☆ Paediatrics ★★★★★☆☆ Paediatric neonatology ★★★★★★★ Paediatric hospital medicine ★★★★★★☆ ### ![Graphic][5] Design: database linked cohort study. ### ![Graphic][6] Setting: Tennessee, USA. ### ![Graphic][7] Patients: 29 507 infants born between 1985 and 2000 whose mothers were enrolled in Medicaid. 209 infants had been exposed to ACE inhibitors in the first trimester only, 202 infants had been exposed to other antihypertensive drugs in the first trimester only, and 29 096 had had no such exposure. Exclusion criteria: evidence of maternal diabetes before or during pregnancy, maternal prescription for angiotensin receptor antagonists, fetal exposure to ACE inhibitors or other antihypertensive drugs beyond the first trimester, or fetal exposure to … [1]: {openurl}?query=rft.jtitle%253DNew%2BEngland%2BJournal%2Bof%2BMedicine%26rft.stitle%253DNEJM%26rft.issn%253D0028-4793%26rft.aulast%253DCooper%26rft.auinit1%253DW.%2BO.%26rft.volume%253D354%26rft.issue%253D23%26rft.spage%253D2443%26rft.epage%253D2451%26rft.atitle%253DMajor%2Bcongenital%2Bmalformations%2Bafter%2Bfirst-trimester%2Bexposure%2Bto%2BACE%2Binhibitors.%26rft_id%253Dinfo%253Adoi%252F10.1056%252FNEJMoa055202%26rft_id%253Dinfo%253Apmid%252F16760444%26rft.genre%253Darticle%26rft_val_fmt%253Dinfo%253Aofi%252Ffmt%253Akev%253Amtx%253Ajournal%26ctx_ver%253DZ39.88-2004%26url_ver%253DZ39.88-2004%26url_ctx_fmt%253Dinfo%253Aofi%252Ffmt%253Akev%253Amtx%253Actx [2]: /lookup/external-ref?access_num=10.1056/NEJMoa055202&link_type=DOI [3]: /lookup/external-ref?access_num=16760444&link_type=MED&atom=%2Febmed%2F12%2F1%2F26.atom [4]: /lookup/external-ref?access_num=000238100800006&link_type=ISI [5]: /embed/inline-graphic-1.gif [6]: /embed/inline-graphic-2.gif [7]: /embed/inline-graphic-3.gif
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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: Commentary About the Canadian research system: no · About a Canadian topic: no | Not applicable | low |
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 | 0.000 | 0.005 |
| 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 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.008 | 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.
The models disagree on parts of this classification; every voice is preserved in the section at the end of the page.
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".