A normal ECG at birth does not exclude significant congenital cardiac conduction disease associated with maternal anti‐Ro antibodies
Bibliographic record
Abstract
Paediatric Rheumatology/Series Editor: P. Woo Letters to the Editor Sir, Isolated congenital complete heart block (CCHB) is a rare complication of pregnancy, strongly associated with maternal anti‐Ro/SSA antibody, which is found in up to 91% of cases [1].The damage occurs during fetal development, heart block generally first being detectable between 16 and 24 weeks of gestation. Only approximately 2% of pregnancies in women with the anti‐Ro antibody are complicated by CCHB [2]. Even in women who have had children with CCHB the risk of recurrence is only 16% [1], despite the stability of the antibody over time. One possible explanation is that subclinical damage to the conduction pathway may be occurring in clinically unaffected siblings. We have recently had a case which illustrates that even clinically significant cardiac conduction disease may not be apparent at birth. We report a woman with Sjögren's syndrome who has had three children. Her first pregnancy, in 1993, was complicated by a Caesarian section as the fetal heart rate could not be heard and the fetus was small for the dates. At birth it was noted that the newborn girl had CCHB. She has had an endocardial pacemaker since the age of 2 yr and is now growing normally.
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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 | 0.014 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.001 | 0.000 |
| Science and technology studies | 0.001 | 0.002 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.000 |
| Research integrity | 0.015 | 0.008 |
| Insufficient payload (model declined to judge) | 0.004 | 0.002 |
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".