5.6 The Control of Hypertension In Pregnancy Study (CHIPS) randomised controlled trial
Bibliographic record
Abstract
Background Most obstetricians believe that BP normalisation in pregnancy reduces maternal complications, but may increase adverse perinatal outcomes. No adequately powered trials of differential BP control have been performed. Objective Determine best management of non-severe pregnancy hypertension. Methods In an open pragmatic international multicentre trial, women at 14+0–33+6 wk gestation with non-proteinuric pre-existing or gestational hypertension, office diastolic blood pressure (dBP) 90–105 mmHg (or 85–105 mmHg if on antihypertensives) and a live fetus were randomised to ‘less tight’ (target dBP 100 mmHg) or ‘tight’ control (target dBP 85 mmHg). The composite primary outcome was pregnancy loss or high level neonatal care for >48 h in the first 28d of life, and the secondary one/more serious maternal complications before 6wks. Outcomes were compared between groups using logistic regression adjusted for key prognostic factors (alpha = 0.05, two-sided, intention-to-treat). Results Of 1030 women randomised, 987 (94 sites) were included in the analysis. 74.6% had pre-existing hypertension. Women in ‘less tight’ (n=497) [vs. ‘tight’ (n = 490)] control had higher mean dBP by 4.5 mmHg (95% CI 3.6, 5.4), but similar rates of the primary (perinatal) outcome [31.4% vs. 30.7%; aOR 1.03, 95% CI 0.78, 1.36] and secondary (maternal) outcome [3.7% vs. 2.0%; aOR 1.74, 95% CI 0.79, 3.84]. Women receiving ‘less tight’ control more frequently developed BP ≥160/110mmHg) (40.4% vs. 27.5%; aOR 1.78, 95% CI 1.35, 2.36). Interpretation ‘Tight’ control is safer for the mother. These data reassure that it has no adverse effects for the baby. A target dBP of 85mmHg should be aimed for. Funding Canadian Institutes of Health Research.
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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 | 0.008 |
| Meta-epidemiology (narrow) | 0.002 | 0.001 |
| Meta-epidemiology (broad) | 0.005 | 0.003 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.002 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.003 | 0.003 |
| Insufficient payload (model declined to judge) | 0.015 | 0.001 |
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".