Abstract P149: Factors Associated With Future Cardiovascular Disease in Women With Hypertensive Disorders of Pregnancy and Gestational Diabetes
Bibliographic record
Abstract
Background and aim: Hypertensive disorders of pregnancy (HDP) and gestational diabetes (GDM) are common complications in pregnancy. The risk of developing premature cardiovascular disease (CVD) is increased in women with a history of these disorders. However, more nuanced risk stratification is needed to identify women who would derive the greatest benefit from early risk reduction. We investigated demographic and clinical factors associated with future CVD in women with a history of HDP or GDM. Method: Women who were aged 15 to 45 years at the time of delivery were identified from among all hospital deliveries in Quebec between 1989 and 2016. Criteria for inclusion in the study were HDP, defined as pre-existing hypertension, gestational hypertension, pre-eclampsia, and superimposed pre-eclampsia, or GDM. Women with HDP or GDM were followed until age 60 years for CVD events, death, or loss to follow-up. CVD events included heart disease, cerebrovascular disease, heart and blood vessel procedures, coronary care unit admission, or mortality prior to age 60 years. We examined the association (hazard ratio, HR; 95% confidence interval, CI) between potential predictor variables and future CVD using Cox proportional hazard regression models. Risk factor variables included sociodemographic, pregnancy-related and perinatal factors recorded at the time of delivery. Results: Hypertension in pregnancy or gestational diabetes occurred in 173,430 (14%) of 1,229,278 women admitted for hospital delivery during the study. CVD events occurred in 3.3% of women with hypertensive disorders of pregnancy or gestational diabetes, of which death occurred in 903 (0.5%) women. The median time to event was 12 years. Neonatal death and stillbirth had the strongest associations with CVD. HRs for CVD were 2.29 (95% CI: 1.62-3.25) for neonatal death vs none, and 2.01 (95% CI: 1.556-2.60) for stillbirth vs none. Maternal age, substance use, low socioeconomic status, tobacco use, and obesity were also associated with increased risk of CVD (Table 1). Conclusion: Future studies should investigate whether these identified factors can reliably predict the risk of CVD and mortality in women with a history of hypertensive disorders of pregnancy and gestational diabetes.
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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 | 0.000 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.003 | 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".