Cardiovascular Health and Adverse Pregnancy Outcomes in Autoimmune Rheumatic Diseases
Bibliographic record
Abstract
Autoimmune rheumatic diseases (ARDs) primarily affect women during their reproductive years, and pregnancy can be enormously challenging in these women. Increased prevalence of adverse pregnancy outcomes (APOs) in these women, such as preterm birth (PTB), small for gestational age (SGA), and preeclampsia, is well recognized. Additionally, there is evidence to suggest that pregnancy may contribute to the progression of preclinical autoimmune disease and APOs might be the clue to such progression.1 In women without ARDs, multiple studies have underscored a link between APOs and the mother’s increased risk of future cardiovascular disease (CVD).2-5 However, it is unclear whether similar risks exist in women with ARDs, such as systemic lupus erythematosus (SLE), antiphospholipid syndrome (APS), and rheumatoid arthritis (RA), and whether CVD-related events somehow translate into APOs in these women. Quantifying and understanding underlying mechanisms are crucial, as cardiovascular (CV) morbidity and mortality are higher in several ARDs.6,7 In this issue of The Journal of Rheumatology , Dhital et al explore the relationship between CV events (CVEs) that occurred during pregnancy and the risks of APOs (PTB, SGA, or a composite of either) among women with ARDs in a large, retrospective population cohort of pregnant women who gave birth to singleton liveborn infants, using relevant linked databases.8 They found higher CVEs in pregnant women with ARDs (1.4%) and APS (5.5%) compared to those who had neither (0.3%). Rates of APOs were also higher in women with ARDs (26.9%) and APS (21.2%) than in those without (15.2%). Additionally, CVEs were linked to a higher risk of composite APOs for all groups under study, with adjusted risk ratios ranging from 1.2 to 1.4. Compared to the control group (those without CVEs or ARDs/APS), the adjusted risk differences of APOs per 100 births were 7.8 (95% … Address correspondence to Dr. V. Ravindran, Centre for Rheumatology, Calicut, Kerala 673009, India. Email: drvinod12{at}gmail.com.
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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 | 0.006 |
| 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 | 0.001 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.001 | 0.002 |
| Insufficient payload (model declined to judge) | 0.002 | 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".