Pulmonary Hypertension in Pregnancy: Maternal and Neonatal Trends and Outcomes [01OP]
Bibliographic record
Abstract
INTRODUCTION: Pulmonary hypertension (PH) is associated with significant maternal and fetal morbidity and mortality. With recent treatment advances, women with PH are electing to continue their pregnancy to term. Our study compared the demographics, comorbidities and clinical outcomes in parturients with PH and without PH. METHODS: We conducted a population-based retrospective cohort study using Nationwide Inpatient Sample (NIS) of Healthcare Costs and Utilization Project (HCUP) database from 2000 to 2014. We used an unconditional logistic regression analyses to estimate the associated risks of maternal and neonatal outcomes. RESULTS: We identified 2,087 cases of PH in pregnancy. Compared to non-PH pregnant women, PH in pregnancy was associated with an increase in hypertensive disorders (23.24% vs. 4.99%, P <0.0001), including pre-eclampsia (13.61% vs. 3.47%, P <0.0001) and eclampsia (0.38% vs. 0.08%, P <0.0001). A 1.9-fold increase in cesarean section rate was observed. The most common maternal post-partum complication was cardiomyopathy (5.70% vs. 0.02%, P <0.0001). The maternal mortality rate was 2.64% compared to 0.01% in controls ( P <0.001). Mortality rate trends have remained stable, while hospital delivery admission rates have risen significantly ( P =0.028). Neonatal outcomes were worse among PH patients, notably higher rates of intra-uterine growth restriction and death, preterm birth and congenital anomalies. CONCLUSION: PH in pregnancy is rare and associated with increased risk of adverse pregnancy, maternal and neonatal outcomes. However, our study found a significantly lower maternal mortality rate compared to those previously quoted in the literature. Given significantly higher risk of thromboembolic events, careful consideration should be given to thromboprophylaxis.
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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 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.002 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.002 | 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".