Prospective validation and assessment of cardiovascular and offspring risk models for pregnant women with congenital heart disease
Objectives Adequate prepregnancy prediction of maternal cardiovascular and offspring risk is important for counselling and management of pregnancy in women with congenital heart disease (CHD). Therefore we performed a study to identify the optimal assessment strategy for estimating the risk of pregn...
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| Veröffentlicht in: | Heart (British Cardiac Society) 2014-09, Vol.100 (17), p.1373-1381 |
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| creator | Balci, Ali Sollie-Szarynska, Krystyna M van der Bijl, Antoinette G L Ruys, Titia P E Mulder, Barbara J M Roos-Hesselink, Jolien W van Dijk, Arie P J Wajon, Elly M C J Vliegen, Hubert W Drenthen, Willem Hillege, Hans L Aarnoudse, Jan G van Veldhuisen, Dirk J Pieper, Petronella G |
| description | Objectives Adequate prepregnancy prediction of maternal cardiovascular and offspring risk is important for counselling and management of pregnancy in women with congenital heart disease (CHD). Therefore we performed a study to identify the optimal assessment strategy for estimating the risk of pregnancy in women with CHD. Methods In this prospective study, we determined the outcomes of 213 pregnancies in 203 women with CHD. The ZAHARA I (Zwangerschap bij Aangeboren HARtAfwijkingen I) and CARPREG (CARdiac disease in PREGnancy) risk scores were calculated for each pregnancy, as was the total number of cardiovascular (TPc) or offspring risk predictors (TPo) from these and other studies combined. Pregnancies were also classified according to the modified WHO classification of maternal cardiovascular risk and according to disease complexity (DC). Results Maternal cardiovascular events occurred during 22 pregnancies (10.3%). Offspring events occurred during 77 pregnancies in 81 children (37.3%). Cardiovascular and offspring event rates increased with higher risk scores, higher TPc or TPo, higher WHO class and greater DC. The highest area under the curve (AUC) for maternal cardiovascular risk was achieved by the WHO class (AUC: 0.77, p |
| doi_str_mv | 10.1136/heartjnl-2014-305597 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_1808678327</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>1552367764</sourcerecordid><originalsourceid>FETCH-LOGICAL-b454t-974c333fd0b81ebfb0eec1a97d4be24c39c505c81765324062ac9e3e518fbcc93</originalsourceid><addsrcrecordid>eNqNkcuOFCEYhYnROBd9A2NI3LgphzvU0ky8JZPoQhN3hKJ-emiroIWqnszWJ5eennHhRlcQ-M4J_B9CLyh5QylXF9fgyrJNU8cIFR0nUvb6ETqlQpnD0ffHbc-l7BTh-gSd1bolhIjeqKfohEnChWHsFP36UnLdgV_iHvDeTXF0S8wJuzRiVyvUOkNacA7YuzLGvHfVr5Mrd0AOoe5KTBtcYv2B5zzCVHHIBe8KbJJrwZvc8vgmLtfY57SBFBc34bu34zFWcBWeoSfBTRWe36_n6Nv7d18vP3ZXnz98unx71Q1CiqXrtfCc8zCSwVAYwkAAPHW9HsUArN31XhLpDdVKciaIYs73wEFSEwbve36OXh97dyX_XKEudo7VwzS5BHmtlhpilDac6X-jUjKutFaioa_-Qrd5Lal9xFJtiG4KiGqUOFK-jbsWCLbNbXbl1lJiDzrtg0570GmPOlvs5X35Osww_gk9-GvAxREY5u3_Vf4GveavLg</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1780735506</pqid></control><display><type>article</type><title>Prospective validation and assessment of cardiovascular and offspring risk models for pregnant women with congenital heart disease</title><source>MEDLINE</source><source>BMJ Journals - NESLi2</source><source>PubMed Central</source><creator>Balci, Ali ; Sollie-Szarynska, Krystyna M ; van der Bijl, Antoinette G L ; Ruys, Titia P E ; Mulder, Barbara J M ; Roos-Hesselink, Jolien W ; van Dijk, Arie P J ; Wajon, Elly M C J ; Vliegen, Hubert W ; Drenthen, Willem ; Hillege, Hans L ; Aarnoudse, Jan G ; van Veldhuisen, Dirk J ; Pieper, Petronella G</creator><creatorcontrib>Balci, Ali ; Sollie-Szarynska, Krystyna M ; van der Bijl, Antoinette G L ; Ruys, Titia P E ; Mulder, Barbara J M ; Roos-Hesselink, Jolien W ; van Dijk, Arie P J ; Wajon, Elly M C J ; Vliegen, Hubert W ; Drenthen, Willem ; Hillege, Hans L ; Aarnoudse, Jan G ; van Veldhuisen, Dirk J ; Pieper, Petronella G ; ZAHARA-II investigators</creatorcontrib><description>Objectives Adequate prepregnancy prediction of maternal cardiovascular and offspring risk is important for counselling and management of pregnancy in women with congenital heart disease (CHD). Therefore we performed a study to identify the optimal assessment strategy for estimating the risk of pregnancy in women with CHD. Methods In this prospective study, we determined the outcomes of 213 pregnancies in 203 women with CHD. The ZAHARA I (Zwangerschap bij Aangeboren HARtAfwijkingen I) and CARPREG (CARdiac disease in PREGnancy) risk scores were calculated for each pregnancy, as was the total number of cardiovascular (TPc) or offspring risk predictors (TPo) from these and other studies combined. Pregnancies were also classified according to the modified WHO classification of maternal cardiovascular risk and according to disease complexity (DC). Results Maternal cardiovascular events occurred during 22 pregnancies (10.3%). Offspring events occurred during 77 pregnancies in 81 children (37.3%). Cardiovascular and offspring event rates increased with higher risk scores, higher TPc or TPo, higher WHO class and greater DC. The highest area under the curve (AUC) for maternal cardiovascular risk was achieved by the WHO class (AUC: 0.77, p<0.0001). AUC for the ZAHARA I risk score was 0.71 (p=0.001), and for the CARPREG risk score 0.57 (p=0.32). All models performed insufficiently in predicting offspring events (AUC≤0.6). Conclusions The WHO classification is the best available risk assessment model for estimating cardiovascular risk in pregnant women with CHD. None of the offspring prediction models perform adequately in our cohort.</description><identifier>ISSN: 1355-6037</identifier><identifier>EISSN: 1468-201X</identifier><identifier>DOI: 10.1136/heartjnl-2014-305597</identifier><identifier>PMID: 25034822</identifier><language>eng</language><publisher>England: BMJ Publishing Group LTD</publisher><subject>Alcohol ; Area Under Curve ; Cardiac arrhythmia ; Cardiovascular disease ; Classification ; Clinical medicine ; Congenital diseases ; Decision Support Techniques ; Defects ; Family medical history ; Female ; Fetal Death ; Germany ; Health risk assessment ; Heart Defects, Congenital - complications ; Heart Defects, Congenital - diagnosis ; Heart Defects, Congenital - mortality ; Heart failure ; Humans ; Infant Mortality ; Infant, Newborn ; Maternal Mortality ; Mortality ; Predictive Value of Tests ; Pregnancy ; Pregnancy Complications, Cardiovascular - diagnosis ; Pregnancy Complications, Cardiovascular - etiology ; Pregnancy Complications, Cardiovascular - mortality ; Prognosis ; Prospective Studies ; Risk Assessment ; Risk Factors ; ROC Curve ; Studies ; Womens health</subject><ispartof>Heart (British Cardiac Society), 2014-09, Vol.100 (17), p.1373-1381</ispartof><rights>Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions</rights><rights>Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.</rights><rights>Copyright: 2014 Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-b454t-974c333fd0b81ebfb0eec1a97d4be24c39c505c81765324062ac9e3e518fbcc93</citedby><cites>FETCH-LOGICAL-b454t-974c333fd0b81ebfb0eec1a97d4be24c39c505c81765324062ac9e3e518fbcc93</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttp://heart.bmj.com/content/100/17/1373.full.pdf$$EPDF$$P50$$Gbmj$$H</linktopdf><linktohtml>$$Uhttp://heart.bmj.com/content/100/17/1373.full$$EHTML$$P50$$Gbmj$$H</linktohtml><link.rule.ids>114,115,314,780,784,3196,23571,27924,27925,77600,77631</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/25034822$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Balci, Ali</creatorcontrib><creatorcontrib>Sollie-Szarynska, Krystyna M</creatorcontrib><creatorcontrib>van der Bijl, Antoinette G L</creatorcontrib><creatorcontrib>Ruys, Titia P E</creatorcontrib><creatorcontrib>Mulder, Barbara J M</creatorcontrib><creatorcontrib>Roos-Hesselink, Jolien W</creatorcontrib><creatorcontrib>van Dijk, Arie P J</creatorcontrib><creatorcontrib>Wajon, Elly M C J</creatorcontrib><creatorcontrib>Vliegen, Hubert W</creatorcontrib><creatorcontrib>Drenthen, Willem</creatorcontrib><creatorcontrib>Hillege, Hans L</creatorcontrib><creatorcontrib>Aarnoudse, Jan G</creatorcontrib><creatorcontrib>van Veldhuisen, Dirk J</creatorcontrib><creatorcontrib>Pieper, Petronella G</creatorcontrib><creatorcontrib>ZAHARA-II investigators</creatorcontrib><title>Prospective validation and assessment of cardiovascular and offspring risk models for pregnant women with congenital heart disease</title><title>Heart (British Cardiac Society)</title><addtitle>Heart</addtitle><description>Objectives Adequate prepregnancy prediction of maternal cardiovascular and offspring risk is important for counselling and management of pregnancy in women with congenital heart disease (CHD). Therefore we performed a study to identify the optimal assessment strategy for estimating the risk of pregnancy in women with CHD. Methods In this prospective study, we determined the outcomes of 213 pregnancies in 203 women with CHD. The ZAHARA I (Zwangerschap bij Aangeboren HARtAfwijkingen I) and CARPREG (CARdiac disease in PREGnancy) risk scores were calculated for each pregnancy, as was the total number of cardiovascular (TPc) or offspring risk predictors (TPo) from these and other studies combined. Pregnancies were also classified according to the modified WHO classification of maternal cardiovascular risk and according to disease complexity (DC). Results Maternal cardiovascular events occurred during 22 pregnancies (10.3%). Offspring events occurred during 77 pregnancies in 81 children (37.3%). Cardiovascular and offspring event rates increased with higher risk scores, higher TPc or TPo, higher WHO class and greater DC. The highest area under the curve (AUC) for maternal cardiovascular risk was achieved by the WHO class (AUC: 0.77, p<0.0001). AUC for the ZAHARA I risk score was 0.71 (p=0.001), and for the CARPREG risk score 0.57 (p=0.32). All models performed insufficiently in predicting offspring events (AUC≤0.6). Conclusions The WHO classification is the best available risk assessment model for estimating cardiovascular risk in pregnant women with CHD. None of the offspring prediction models perform adequately in our cohort.</description><subject>Alcohol</subject><subject>Area Under Curve</subject><subject>Cardiac arrhythmia</subject><subject>Cardiovascular disease</subject><subject>Classification</subject><subject>Clinical medicine</subject><subject>Congenital diseases</subject><subject>Decision Support Techniques</subject><subject>Defects</subject><subject>Family medical history</subject><subject>Female</subject><subject>Fetal Death</subject><subject>Germany</subject><subject>Health risk assessment</subject><subject>Heart Defects, Congenital - complications</subject><subject>Heart Defects, Congenital - diagnosis</subject><subject>Heart Defects, Congenital - mortality</subject><subject>Heart failure</subject><subject>Humans</subject><subject>Infant Mortality</subject><subject>Infant, Newborn</subject><subject>Maternal Mortality</subject><subject>Mortality</subject><subject>Predictive Value of Tests</subject><subject>Pregnancy</subject><subject>Pregnancy Complications, Cardiovascular - diagnosis</subject><subject>Pregnancy Complications, Cardiovascular - etiology</subject><subject>Pregnancy Complications, Cardiovascular - mortality</subject><subject>Prognosis</subject><subject>Prospective Studies</subject><subject>Risk Assessment</subject><subject>Risk Factors</subject><subject>ROC Curve</subject><subject>Studies</subject><subject>Womens health</subject><issn>1355-6037</issn><issn>1468-201X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2014</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><recordid>eNqNkcuOFCEYhYnROBd9A2NI3LgphzvU0ky8JZPoQhN3hKJ-emiroIWqnszWJ5eennHhRlcQ-M4J_B9CLyh5QylXF9fgyrJNU8cIFR0nUvb6ETqlQpnD0ffHbc-l7BTh-gSd1bolhIjeqKfohEnChWHsFP36UnLdgV_iHvDeTXF0S8wJuzRiVyvUOkNacA7YuzLGvHfVr5Mrd0AOoe5KTBtcYv2B5zzCVHHIBe8KbJJrwZvc8vgmLtfY57SBFBc34bu34zFWcBWeoSfBTRWe36_n6Nv7d18vP3ZXnz98unx71Q1CiqXrtfCc8zCSwVAYwkAAPHW9HsUArN31XhLpDdVKciaIYs73wEFSEwbve36OXh97dyX_XKEudo7VwzS5BHmtlhpilDac6X-jUjKutFaioa_-Qrd5Lal9xFJtiG4KiGqUOFK-jbsWCLbNbXbl1lJiDzrtg0570GmPOlvs5X35Osww_gk9-GvAxREY5u3_Vf4GveavLg</recordid><startdate>20140901</startdate><enddate>20140901</enddate><creator>Balci, Ali</creator><creator>Sollie-Szarynska, Krystyna M</creator><creator>van der Bijl, Antoinette G L</creator><creator>Ruys, Titia P E</creator><creator>Mulder, Barbara J M</creator><creator>Roos-Hesselink, Jolien W</creator><creator>van Dijk, Arie P J</creator><creator>Wajon, Elly M C J</creator><creator>Vliegen, Hubert W</creator><creator>Drenthen, Willem</creator><creator>Hillege, Hans L</creator><creator>Aarnoudse, Jan G</creator><creator>van Veldhuisen, Dirk J</creator><creator>Pieper, Petronella G</creator><general>BMJ Publishing Group LTD</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>88I</scope><scope>8AF</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>BTHHO</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>HCIFZ</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>M2P</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>Q9U</scope><scope>7X8</scope><scope>7QO</scope><scope>8FD</scope><scope>FR3</scope><scope>P64</scope></search><sort><creationdate>20140901</creationdate><title>Prospective validation and assessment of cardiovascular and offspring risk models for pregnant women with congenital heart disease</title><author>Balci, Ali ; Sollie-Szarynska, Krystyna M ; van der Bijl, Antoinette G L ; Ruys, Titia P E ; Mulder, Barbara J M ; Roos-Hesselink, Jolien W ; van Dijk, Arie P J ; Wajon, Elly M C J ; Vliegen, Hubert W ; Drenthen, Willem ; Hillege, Hans L ; Aarnoudse, Jan G ; van Veldhuisen, Dirk J ; Pieper, Petronella G</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-b454t-974c333fd0b81ebfb0eec1a97d4be24c39c505c81765324062ac9e3e518fbcc93</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2014</creationdate><topic>Alcohol</topic><topic>Area Under Curve</topic><topic>Cardiac arrhythmia</topic><topic>Cardiovascular disease</topic><topic>Classification</topic><topic>Clinical medicine</topic><topic>Congenital diseases</topic><topic>Decision Support Techniques</topic><topic>Defects</topic><topic>Family medical history</topic><topic>Female</topic><topic>Fetal Death</topic><topic>Germany</topic><topic>Health risk assessment</topic><topic>Heart Defects, Congenital - complications</topic><topic>Heart Defects, Congenital - diagnosis</topic><topic>Heart Defects, Congenital - mortality</topic><topic>Heart failure</topic><topic>Humans</topic><topic>Infant Mortality</topic><topic>Infant, Newborn</topic><topic>Maternal Mortality</topic><topic>Mortality</topic><topic>Predictive Value of Tests</topic><topic>Pregnancy</topic><topic>Pregnancy Complications, Cardiovascular - diagnosis</topic><topic>Pregnancy Complications, Cardiovascular - etiology</topic><topic>Pregnancy Complications, Cardiovascular - mortality</topic><topic>Prognosis</topic><topic>Prospective Studies</topic><topic>Risk Assessment</topic><topic>Risk Factors</topic><topic>ROC Curve</topic><topic>Studies</topic><topic>Womens health</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Balci, Ali</creatorcontrib><creatorcontrib>Sollie-Szarynska, Krystyna M</creatorcontrib><creatorcontrib>van der Bijl, Antoinette G L</creatorcontrib><creatorcontrib>Ruys, Titia P E</creatorcontrib><creatorcontrib>Mulder, Barbara J M</creatorcontrib><creatorcontrib>Roos-Hesselink, Jolien W</creatorcontrib><creatorcontrib>van Dijk, Arie P J</creatorcontrib><creatorcontrib>Wajon, Elly M C J</creatorcontrib><creatorcontrib>Vliegen, Hubert W</creatorcontrib><creatorcontrib>Drenthen, Willem</creatorcontrib><creatorcontrib>Hillege, Hans L</creatorcontrib><creatorcontrib>Aarnoudse, Jan G</creatorcontrib><creatorcontrib>van Veldhuisen, Dirk J</creatorcontrib><creatorcontrib>Pieper, Petronella G</creatorcontrib><creatorcontrib>ZAHARA-II investigators</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Science Database (Alumni Edition)</collection><collection>STEM Database</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>BMJ Journals</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>SciTech Premium Collection</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Science Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>ProQuest Central Basic</collection><collection>MEDLINE - Academic</collection><collection>Biotechnology Research Abstracts</collection><collection>Technology Research Database</collection><collection>Engineering Research Database</collection><collection>Biotechnology and BioEngineering Abstracts</collection><jtitle>Heart (British Cardiac Society)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Balci, Ali</au><au>Sollie-Szarynska, Krystyna M</au><au>van der Bijl, Antoinette G L</au><au>Ruys, Titia P E</au><au>Mulder, Barbara J M</au><au>Roos-Hesselink, Jolien W</au><au>van Dijk, Arie P J</au><au>Wajon, Elly M C J</au><au>Vliegen, Hubert W</au><au>Drenthen, Willem</au><au>Hillege, Hans L</au><au>Aarnoudse, Jan G</au><au>van Veldhuisen, Dirk J</au><au>Pieper, Petronella G</au><aucorp>ZAHARA-II investigators</aucorp><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Prospective validation and assessment of cardiovascular and offspring risk models for pregnant women with congenital heart disease</atitle><jtitle>Heart (British Cardiac Society)</jtitle><addtitle>Heart</addtitle><date>2014-09-01</date><risdate>2014</risdate><volume>100</volume><issue>17</issue><spage>1373</spage><epage>1381</epage><pages>1373-1381</pages><issn>1355-6037</issn><eissn>1468-201X</eissn><abstract>Objectives Adequate prepregnancy prediction of maternal cardiovascular and offspring risk is important for counselling and management of pregnancy in women with congenital heart disease (CHD). Therefore we performed a study to identify the optimal assessment strategy for estimating the risk of pregnancy in women with CHD. Methods In this prospective study, we determined the outcomes of 213 pregnancies in 203 women with CHD. The ZAHARA I (Zwangerschap bij Aangeboren HARtAfwijkingen I) and CARPREG (CARdiac disease in PREGnancy) risk scores were calculated for each pregnancy, as was the total number of cardiovascular (TPc) or offspring risk predictors (TPo) from these and other studies combined. Pregnancies were also classified according to the modified WHO classification of maternal cardiovascular risk and according to disease complexity (DC). Results Maternal cardiovascular events occurred during 22 pregnancies (10.3%). Offspring events occurred during 77 pregnancies in 81 children (37.3%). Cardiovascular and offspring event rates increased with higher risk scores, higher TPc or TPo, higher WHO class and greater DC. The highest area under the curve (AUC) for maternal cardiovascular risk was achieved by the WHO class (AUC: 0.77, p<0.0001). AUC for the ZAHARA I risk score was 0.71 (p=0.001), and for the CARPREG risk score 0.57 (p=0.32). All models performed insufficiently in predicting offspring events (AUC≤0.6). Conclusions The WHO classification is the best available risk assessment model for estimating cardiovascular risk in pregnant women with CHD. None of the offspring prediction models perform adequately in our cohort.</abstract><cop>England</cop><pub>BMJ Publishing Group LTD</pub><pmid>25034822</pmid><doi>10.1136/heartjnl-2014-305597</doi><tpages>9</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Alcohol Area Under Curve Cardiac arrhythmia Cardiovascular disease Classification Clinical medicine Congenital diseases Decision Support Techniques Defects Family medical history Female Fetal Death Germany Health risk assessment Heart Defects, Congenital - complications Heart Defects, Congenital - diagnosis Heart Defects, Congenital - mortality Heart failure Humans Infant Mortality Infant, Newborn Maternal Mortality Mortality Predictive Value of Tests Pregnancy Pregnancy Complications, Cardiovascular - diagnosis Pregnancy Complications, Cardiovascular - etiology Pregnancy Complications, Cardiovascular - mortality Prognosis Prospective Studies Risk Assessment Risk Factors ROC Curve Studies Womens health |
| title | Prospective validation and assessment of cardiovascular and offspring risk models for pregnant women with congenital heart disease |
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