Abstract 10309: Pregnancy Outcomes in Women with Hypertrophic Cardiomyopathy
Bibliographic record
Abstract
Introduction: Hypertrophic cardiomyopathy (HCM) is a genetic disorder often complicated by heart failure, embolic stroke, and sudden cardiac death. Pregnancy causes hemodynamic changes which may be deleterious in patients with HCM. Existing cohort studies of maternal and fetal outcomes of pregnant patients with HCM are limited by small sample sizes. We performed a systematic review of maternal and fetal outcomes of pregnancy in patients with established HCM. Methods: We searched MEDLINE, EMBASE, and Cochrane Library databases for studies reporting maternal or fetal outcomes in pregnant patients with HCM. The primary outcomes were maternal death, stillbirth, and fetal death. Secondary maternal outcomes included: sustained ventricular tachycardia (VT), any VT (including sustained and non-sustained), atrial fibrillation (AF), syncope, caesarean delivery, and pre-eclampsia or eclampsia. The secondary fetal outcome was preterm birth. We used a random effects model to determine pooled incidences of outcomes. Results: A total of 18 studies with 5236 pregnancies were included. The incidence of maternal death was 0.2%. Similarly, the incidence of neonatal death was 0.2%. The incidence of maternal and neonatal death was too low across studies to derive pooled estimates. The rate of stillbirth was low at 1% (95% CI, 0-3%) and rate of preterm birth was 22% (95% CI, 18-25%). The rates of sustained VT, any VT, AF, heart failure, and syncope were 1% (0-1%), 6% (4-8%), 4% (2-6%), 5% (3-8%), and 9% (3-14%), respectively. Postpartum hemorrhage, preeclampsia or eclampsia, and cesarean section complicated 2% (1-4%), 4% (2-6%), and 43% (32-54%) of pregnancies, respectively. Conclusions: Women with HCM looking to become pregnant can be reassured that the risk of death, stillbirth, or neonatal demise are low. However, they are at risk for several non-fatal cardiac and pregnancy related complications.
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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 | 0.007 | 0.035 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.005 | 0.007 |
| Bibliometrics | 0.007 | 0.007 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.002 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.005 | 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".