Objectives Compare the predictive performance of Framingham Risk Score (FRS), Pooled Cohort Equations (PCEs) and Systematic COronary Risk Evaluation (SCORE) model between women with and without a... Show moreObjectives Compare the predictive performance of Framingham Risk Score (FRS), Pooled Cohort Equations (PCEs) and Systematic COronary Risk Evaluation (SCORE) model between women with and without a history of hypertensive disorders of pregnancy (hHDP) and determine the effects of recalibration and refitting on predictive performance. Methods We included 29 751 women, 6302 with hHDP and 17 369 without. We assessed whether models accurately predicted observed 10-year cardiovascular disease (CVD) risk (calibration) and whether they accurately distinguished between women developing CVD during follow-up and not (discrimination), separately for women with and without hHDP. We also recalibrated (updating intercept and slope) and refitted (recalculating coefficients) the models. Results Original FRS and PCEs overpredicted 10-year CVD risks, with expected:observed (E:O) ratios ranging from 1.51 (for FRS in women with hHDP) to 2.29 (for PCEs in women without hHDP), while E:O ratios were close to 1 for SCORE. Overprediction attenuated slightly after recalibration for FRS and PCEs in both hHDP groups. Discrimination was reasonable for all models, with C-statistics ranging from 0.70-0.81 (women with hHDP) and 0.72-0.74 (women without hHDP). C-statistics improved slightly after refitting 0.71-0.83 (with hHDP) and 0.73-0.80 (without hHDP). The E:O ratio of the original PCE model was statistically significantly better in women with hHDP compared with women without hHDP. Conclusions SCORE performed best in terms of both calibration and discrimination, while FRS and PCEs overpredicted risk in women with and without hHDP, but improved after recalibrating and refitting the models. No separate model for women with hHDP seems necessary, despite their higher baseline risk. Show less
Russo, F.M.; Mian, P.; Krekels, E.H.; Calsteren, K. van; Tibboel, D.; Deprest, J.; Allegaert, K. 2019
Objective A cancer diagnosis during pregnancy may be considered as an emotional challengefor pregnant women and their partners. We aimed to identify women and partners at risk for highlevels of... Show moreObjective A cancer diagnosis during pregnancy may be considered as an emotional challengefor pregnant women and their partners. We aimed to identify women and partners at risk for highlevels of distress based on their coping profile.Methods Sixty‐one pregnant women diagnosed with cancer and their partners filled out theCognitive Emotion Regulation Questionnaire (CERQ) and the newly constructed Cancer andPregnancy Questionnaire (CPQ). K‐means cluster analysis was performed on the CERQ scales.Scores on the CPQ were compared between the women and their partners and between theCERQ‐clusters.Results Comparison of women and partners on the CPQ did not reveal significant differenceson distress about the child’s health, the cancer disease, and the pregnancy or on information sat-isfaction (P = .16, P = .44, P = .50, and P = .47, respectively). However, women were more inclinedto maintain the pregnancy than their partners (P = .011). Three clusters were retrieved based onthe CERQ scales, characterized by positive coping, internalizing coping, and blaming. Women andpartners using internalizing strategies had significantly higher scores on concerns about thechild’s health (P = .039), the disease and treatment (P < .001), and the pregnancy and delivery(P = .009) compared with positive and blaming strategies. No cluster differences were foundfor information satisfaction (P = .71) and tendency to maintain the pregnancy (P = .35).Conclusion Women and partners using internalizing coping strategies deal with the highestlevels of distress and may benefit from additional psychosocial support. Show less
We investigated whether pregnancy loss increases the risk of arterial thrombosis in young women. Women (age 18-50 years) with ischaemic stroke (IS) or myocardial infarction (MI) and at least one... Show moreWe investigated whether pregnancy loss increases the risk of arterial thrombosis in young women. Women (age 18-50 years) with ischaemic stroke (IS) or myocardial infarction (MI) and at least one pregnancy were compared for pregnancy loss in a control group. Odds ratios (OR) with 95% confidence intervals (CI), adjusted for matching variables, cardiovascular risk factors, cardiovascular family history and the presence of antiphospholipid antibodies, were calculated for the number of pregnancy losses as well as the type of unsuccessful pregnancy (early miscarriage, late miscarriage and stillbirth). 165 IS cases, 218 MI cases and 743 controls were included. Women with multiple (>= 3) pregnancy loss had a doubled risk of arterial thrombosis (OR 2.37, 95% CI 0.99-5.70) compared with women without pregnancy loss, similarly to women who experienced stillbirth (OR 1.68, 95% CI 0.79-3.55). Both relative risks were higher for IS (OR 3.51, 95% CI 1.08-11.35 and 2.06, 95% CI 0.81-5.23, respectively) than for MI (OR 2.04, 95% CI 0.71-5.86 and 1.04, 95% CI 0.39-2.79). Adjustment for antiphospholipid antibodies did not affect the estimates. Multiple pregnancy loss and stillbirth increases the risk of IS and, to a lesser extent, of MI, even when other cardiovascular risk factors and antiphospholipid antibodies are accounted for. Show less