{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,13]],"date-time":"2026-08-13T13:31:18Z","timestamp":1786627878536,"version":"build-2736575974"},"reference-count":53,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2026,7,8]],"date-time":"2026-07-08T00:00:00Z","timestamp":1783468800000},"content-version":"vor","delay-in-days":7,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T00:00:00Z","timestamp":1782864000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100000030","name":"Centers for Disease Control and Prevention","doi-asserted-by":"publisher","award":["DD15\u20101506"],"award-info":[{"award-number":["DD15\u20101506"]}],"id":[{"id":"10.13039\/100000030","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000030","name":"Centers for Disease Control and Prevention","doi-asserted-by":"publisher","award":["DD19\u20101902"],"award-info":[{"award-number":["DD19\u20101902"]}],"id":[{"id":"10.13039\/100000030","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Birth Defects Research"],"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Survival to reproductive age is common among women with congenital heart disease (CHD). We evaluated fetal and obstetric complications in a population\u2010based cohort of women with CHD enrolled in Georgia (GA) Medicaid.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We identified 3904 pregnancies (96.0% singleton) among 2267 women with CHD, ages 11\u201350 (49.2% Black; 76.3% urban), enrolled in GA Medicaid from 2008 to 2019. Diagnoses and outcomes were defined using International Classification of Diseases (ICD) codes. Associations between CHD anatomic group and fetal and obstetric outcomes were assessed using chi\u2010square tests. Multivariate logistic regression models were adjusted for covariates, using isolated coronary anomalies as the reference group.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Obstetric complications occurred in 36.2% of pregnancies and did not differ significantly by CHD anatomic group (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.5301). Fetal complications were significantly more common in all CHD groups compared with coronary anomalies, including higher prematurity and fetal growth restriction (FGR) rates (prematurity:\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.0001; FGR:\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.0238). In multivariate analysis, complex right ventricular outflow tract (RVOT) defects, shunts, univentricular lesions, transposition of the great arteries (TGA), left\u2010sided and right\u2010sided valve lesions were associated with increased odds of fetal complications compared to coronary anomaly CHD [aOR, 95% CI: complex RVOT 4.85, 1.85\u201312.71; shunt 4.00, 1.56\u201310.26; univentricular: 3.65, 1.35\u20139.90; TGA: 3.64, 1.24\u201310.63; left\u2010sided valve: 3.23, 1.26\u20138.31; and right\u2010sided valve: 3.11, 1.19\u20138.12].\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Pregnancies among women with CHD carry increased risk of prematurity and FGR rates across CHD anatomic groups compared with coronary anomalies. Close monitoring for fetal and obstetric complications is warranted regardless of CHD subtype, including those traditionally considered to have lower maternal risk.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/bdr2.70085","type":"journal-article","created":{"date-parts":[[2026,7,9]],"date-time":"2026-07-09T03:26:52Z","timestamp":1783567612000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Fetal and Obstetric Complications Among Pregnant Women With Congenital Heart Disease in a Georgia Medicaid Dataset"],"prefix":"10.1002","volume":"118","author":[{"given":"Cheryl L.","family":"Raskind\u2010Hood","sequence":"first","affiliation":[{"name":"Department of Epidemiology, Rollins School of Public Health Emory University  Atlanta Georgia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-3576-5644","authenticated-orcid":false,"given":"Travis M.","family":"Wilson","sequence":"additional","affiliation":[{"name":"Emory University School of Medicine  Atlanta Georgia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shayli","family":"Patel","sequence":"additional","affiliation":[{"name":"Northwestern University Feinberg School of Medicine  Chicago Illinois USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"suffix":"III","given":"Fred H.","family":"Rodriguez","sequence":"additional","affiliation":[{"name":"Emory University School of Medicine  Atlanta Georgia USA"},{"name":"Children's Healthcare of Atlanta Cardiology Inc.  Atlanta Georgia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alex","family":"Haffner","sequence":"additional","affiliation":[{"name":"Emory University School of Medicine  Atlanta Georgia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2803-8030","authenticated-orcid":false,"given":"Vijaya","family":"Kancherla","sequence":"additional","affiliation":[{"name":"Department of Epidemiology, Rollins School of Public Health Emory University  Atlanta Georgia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lindsey","family":"Ivey","sequence":"additional","affiliation":[{"name":"Department of Epidemiology, Rollins School of Public Health Emory University  Atlanta Georgia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wendy M.","family":"Book","sequence":"additional","affiliation":[{"name":"Department of Epidemiology, Rollins School of Public Health Emory University  Atlanta Georgia USA"},{"name":"Emory University School of Medicine  Atlanta Georgia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,7,8]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2024.10763"},{"key":"e_1_2_12_3_1","volume-title":"Clinical Classifications Software (CCS) for ICD\u20109\u2010CM","author":"Agency for Healthcare Research and Quality","year":"2015"},{"key":"e_1_2_12_4_1","volume-title":"Clinical Classifications Software Refined (CCSR) for ICD\u201010\u2010CM Diagnoses","author":"Agency for Healthcare Research and Quality","year":"2026"},{"key":"e_1_2_12_5_1","doi-asserted-by":"publisher","DOI":"10.1002\/bdra.23573"},{"key":"e_1_2_12_6_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0284893"},{"key":"e_1_2_12_7_1","doi-asserted-by":"publisher","DOI":"10.1097\/GRF.0000000000000753"},{"key":"e_1_2_12_8_1","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0000000000004824"},{"key":"e_1_2_12_9_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1475\u20106773.2012.01449.x"},{"key":"e_1_2_12_10_1","volume-title":"International Classification of Diseases, Ninth Revision, Clinical Modification (ICD\u20109\u2010CM)","author":"Centers for Disease Control and Prevention, National Center for Health Statistics","year":"2011"},{"key":"e_1_2_12_11_1","volume-title":"International Classification of Diseases, Tenth Revision, Clinical Modification (ICD\u201010\u2010CM)","author":"Centers for Disease Control and Prevention, National Center for Health Statistics","year":"2015"},{"key":"e_1_2_12_12_1","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0000000000004972"},{"key":"e_1_2_12_13_1","doi-asserted-by":"publisher","DOI":"10.1097\/ACO.0000000000001208"},{"key":"e_1_2_12_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2021.02.033"},{"key":"e_1_2_12_15_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCOUTCOMES.119.006311"},{"key":"e_1_2_12_16_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.115.019307"},{"key":"e_1_2_12_17_1","doi-asserted-by":"publisher","DOI":"10.1161\/JAHA.120.017834"},{"key":"e_1_2_12_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/s0029\u20107844(99)00393\u20102"},{"key":"e_1_2_12_19_1","doi-asserted-by":"publisher","DOI":"10.1097\/GRF.0000000000000349"},{"issue":"166","key":"e_1_2_12_20_1","first-page":"1","article-title":"2013 NCHS Urban\u2013Rural Classification Scheme for Counties","volume":"2","author":"Ingram D. 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