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 distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.002 | 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 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 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 teacher head, 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".