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Abstract 15319: Impact of Atherosclerotic Cardiovascular Disease Risk Factors on Pregnancy Outcomes in Women With Heart Disease

2023· article· en· W4389952895 on OpenAlexaff
Beatriz Aldara Fernandez Campos, Jasmine Grewal, Marla Kiess, Birgit Pfaller-Eiwegger, Danielle Massarella, Samuel C. Siu, Candice K. Silversides

Bibliographic record

VenueCirculation · 2023
Typearticle
Languageen
FieldMedicine
TopicCardiovascular Issues in Pregnancy
Canadian institutionsSt. Paul's HospitalLondon Health Sciences CentreUniversity of Toronto
Fundersnot available
KeywordsMedicineMacePreeclampsiaInternal medicineMyocardial infarctionHeart diseaseRisk factorPregnancyCardiologyDyslipidemiaHeart failureObstetricsGestational diabetesStroke (engine)DiseaseGestation

Abstract

fetched live from OpenAlex

Introduction: The impact of atherosclerotic cardiovascular disease (ASCVD) risk factors on pregnancy outcomes in women with pre-existing heart disease (HD) has not been examined. Aim: To determine the risk of major adverse cardiovascular events (MACE), preeclampsia and fetal events in women with HD stratified according to the presence of ASCVD risk factors. Methods: We studied a consecutive cohort of pregnant women with heart disease. ASCVD risk factors included any of the following: obesity, hypertension, dyslipidemia, diabetes or smoking. Primary outcomes were MACE (heart failure, cardiac arrest, CV death, stroke and myocardial infarction), preeclampsia and adverse fetal events (pre-term birth, small for gestational age, intraventricular hemorrhage, neonatal death and respiratory distress syndrome). Univariate logistic regression was used to determine the odds of adverse outcomes. Results: In total, 1656 pregnancies (congenital heart disease n=1041, acquired heart disease n= 420, isolated arrhythmia n=195) were included. At least one ASCVD risk factor was present in 24% of pregnancies. Overall, MACE occurred in 7.1%, preeclampsia in 4.3% and adverse fetal events in 30.1% of the pregnancies. Compared to pregnancies in women without ASCVD risk factors, those with ASCVD risk factors were more likely to have pregnancies complicated by MACE (9.7% vs 6.3%, p= 0.025), preeclampsia (8.3% vs 3.4%, p < 0.001), and fetal events (38.5% vs 27.5%, p <0.001). There were differences in maternal and fetal outcomes with or without ASCVD risk factors when stratified by diagnosis (acquired heart disease, congenital heart disease, isolated arrhythmias) (Figure 1). Conclusions: The presence of ASCVD risk factors in women with heart disease is associated with worse maternal and fetal outcomes. Modification of ASCVD risk factors may improve pregnancy outcomes.

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How this classification was reachedexpand

Full frame distilled prediction

Teacher imitation

Not 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.

metaresearch head score (Codex)0.000
metaresearch head score (Gemma)0.000
Version: codex-gemma-dda1882f352aValidation status: machine_predicted_unvalidated
Candidate categoriesnone
Consensus categoriesnone
DomainCandidate signal: none · Consensus signal: none
Study designCandidate signal: Observational · Consensus signal: Observational
GenreCandidate signal: Empirical · Consensus signal: Empirical
Teacher disagreement score0.109
Threshold uncertainty score0.910

Codex and Gemma teacher scores by category

CategoryCodexGemma
Metaresearch0.0000.000
Meta-epidemiology (narrow)0.0000.000
Meta-epidemiology (broad)0.0010.001
Bibliometrics0.0000.001
Science and technology studies0.0000.000
Scholarly communication0.0000.000
Open science0.0000.000
Research integrity0.0000.000
Insufficient payload (model declined to judge)0.0000.000

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.

Opus teacher head0.023
GPT teacher head0.281
Teacher spread0.257 · how far apart the two teachers sit on this one work
Validation statusscore_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from it

Classification

machine, unvalidated

Machine predicted; a candidate call from one teacher head, not a consensus.

The models applied no category: nothing in the taxonomy fit this work.
Study designObservational
Domainnot available
GenreEmpirical

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".

Quick stats

Citations0
Published2023
Admission routes1
Has abstractyes

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