Characterization of cardiac arrhythmias and maternal–fetal outcomes in pregnant women: A prospective cohort study
Bibliographic record
Abstract
Introduction and Objectives: Cardiovascular disease is a common cause of morbidity and mortality in pregnant women. Arrhythmias are common complications during pregnancy; however, the data are limited. Our goal was to characterize the epidemiology, clinical presentation, and impact of cardiac arrhythmias on maternal-fetal outcomes. Methods: A prospective cohort study from the Colombian Registry of Pregnancy and Cardiovascular Disease was carried out from 2016 to 2019. All patients with tachyarrhythmia or bradyarrhythmia and a minimum follow-up of six months after delivery were included. The primary outcome was a composite of cardiac events defined as pulmonary edema, symptomatic sustained arrhythmia requiring specific therapy, stroke, cardiac arrest, or maternal death. Secondary outcomes were other cardiac, neonatal, and obstetric events. Results: Arrhythmias were the most common cause of referral to our dedicated cardio-obstetric clinic. A total of 92 patients were included, mean age 27±6 years; 8.7% had previous structural heart disease, and cardiology consultation was delayed in 79.4%. The most common arrhythmias were premature ventricular contractions (33%) and paroxysmal reentrant supraventricular tachycardias (15%); 11 patients (12%) had cardiac implantable electronic devices. Cardiac events occurred in 18.4% of patients, obstetric events occurred in 6.5%, and one caesarean was indicated in the context of symptomatic severe mitral stenosis. Adverse neonatal outcomes were observed in 24.3% of newborns. Conclusions: Arrhythmias were the most common cause of referral to a dedicated cardio-obstetric clinic; most had a benign course. Adverse maternal cardiovascular outcomes were significant and there was a high rate of obstetric and neonatal adverse events, underlining the importance of multidisciplinary care. Introdução e objetivos: As doenças cardiovasculares são uma causa comum de morbidade e mortalidade em mulheres grávidas. As arritmias são complicações comuns durante a gravidez; no entanto, há dados limitados. O nosso objetivo foi caracterizar a epidemiologia, a apresentação clínica e os desfechos das arritmias cardíacas nos desfechos materno-fetais. Métodos: Coorte prospetiva do Registo de Gravidez e Doenças Cardiovasculares (REMEC) foi realizada entre 2016 e 2019. Foram incluídas todas as pacientes com taquiarritmia ou bradiarritmia e seguimento mínimo de seis meses após o parto. O desfecho primário foi um composto de eventos cardíacos definidos como edema pulmonar, arritmia sustentada sintomática que requer terapia específica, acidente vascular cerebral, parada cardíaca ou morte materna; os desfechos secundários incluíram outros eventos cardíacos, neonatais e obstétricos. Resultados: foram incluídas 92 pacientes, a média de idade foi de 27 (± 6) anos, 8,7% apresentavam cardiopatia estrutural prévia e 79,4% tiveram atraso na consulta de cardiologia. As arritmias mais comuns foram contrações ventriculares prematuras (33%) e taquicardias supraventriculares reentrantes paroxísticas (15%); 11 pacientes (12%). tinham dispositivos cardíacos eletrónicos implantáveis. O eventos cardíacos estiveram presente em 18,4%. Intercorrências obstétricas ocorreram em 6,5% das pacientes, sendo indicada uma cesariana no contexto de estenose mitral grave sintomática. Desfechos neonatais adversos estiveram presentes em 24,3% dos recém-nascidos. Conclusões: As arritmias são a causa mais comum de encaminhamento para uma clínica cardio-obstétrica dedicada; a maioria delas tem um curso benigno. Desfechos cardiovasculares maternos adversos foram significativos e uma taxa importante de eventos adversos obstétricos e neonatais, destacando a importância do cuidado multidisciplinar.
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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 | 0.003 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.001 | 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".