{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,18]],"date-time":"2026-10-18T02:50:42Z","timestamp":1792291842847,"version":"4.4.0"},"reference-count":39,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2025,3,19]],"date-time":"2025-03-19T00:00:00Z","timestamp":1742342400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["BJOG"],"published-print":{"date-parts":[[2026,2]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>We aim to increase knowledge on pregnancy and delivery risks in vascular Ehlers\u2013Danlos Syndrome (vEDS). Our outcomes can contribute to establishing future guidelines for pregnancy and delivery management in women with vEDS.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Retrospective multicentre cohort study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>\n                      Women with vEDS due to pathogenic\/likely pathogenic (P\/LP)\n                      <jats:italic>COL3A1<\/jats:italic>\n                      variants are at increased risk for arterial dissection and pregnancy\u2010related complications during pregnancy and delivery.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Population<\/jats:title>\n                    <jats:p>\n                      Women with a P\/LP\n                      <jats:italic>COL3A1<\/jats:italic>\n                      variant were included from 2019 until 2021.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Genetic and clinical data was collected through retrospective analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Main Outcome Measures<\/jats:title>\n                    <jats:p>Description of the genotype and pregnancy\u2010related outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      We collected information about 121 pregnancies of 43 women with vEDS, including nine women with a haploinsufficient variant. Neither uterine rupture nor life\u2010threatening or fatal vascular events occurred in the perinatal period. The miscarriage rate was 19% (23\/121) and 19.1% of the live births were preterm (18\/94). Miscarriages were significantly more frequent in women with a glycine substitution in\n                      <jats:italic>COL3A1<\/jats:italic>\n                      compared to other\n                      <jats:italic>COL3A1<\/jats:italic>\n                      variant types (19\/23, 82.6%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.018). Thirty\u2010four women had a vaginal birth (79.1%), including 1\/7 with known vEDS. Eight deliveries were complicated by severe perineal tears, and six by postpartum haemorrhage.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>No pregnancy\u2010related deaths, arterial dissections or uterine ruptures occurred in our cohort. Since no life\u2010threatening events occurred during pregnancy and delivery, discouragement of pregnancy in all women with vEDS in current guidelines might be too strict. Based on these data, we propose a shared decision\u2010making process.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/1471-0528.18142","type":"journal-article","created":{"date-parts":[[2025,3,19]],"date-time":"2025-03-19T05:01:27Z","timestamp":1742360487000},"page":"463-470","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Pregnancy and Delivery Outcomes in Vascular Ehlers\u2013Danlos Syndrome: A Retrospective Multicentre Cohort Study"],"prefix":"10.1111","volume":"133","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1195-6054","authenticated-orcid":false,"given":"Lisa M.","family":"van den Bersselaar","sequence":"first","affiliation":[{"name":"Department of Clinical Genetics, Erasmus MC University Medical Center  Rotterdam the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ingrid M. B. H.","family":"van de Laar","sequence":"additional","affiliation":[{"name":"Department of Clinical Genetics, Erasmus MC University Medical Center  Rotterdam the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marieke J. H.","family":"Baars","sequence":"additional","affiliation":[{"name":"Department of Human Genetics, Amsterdam UMC Vrije Universiteit Amsterdam  Amsterdam the Netherlands"},{"name":"Department of Human Genetics, Amsterdam UMC University of Amsterdam  Amsterdam the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Annette","family":"Baas","sequence":"additional","affiliation":[{"name":"Department of Genetics University Medical Center Utrecht  Utrecht the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eelco","family":"Dulfer","sequence":"additional","affiliation":[{"name":"Department of Genetics University Medical Center Groningen  Groningen the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Apollonia T. J. M.","family":"Helderman\u2010van den Enden","sequence":"additional","affiliation":[{"name":"Clinical Genetics Maastricht University Medical Center  Maastricht the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yvonne","family":"Hilhorst\u2010Hofstee","sequence":"additional","affiliation":[{"name":"Department of Clinical Genetics Leiden University Medical Center (LUMC)  Leiden the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert M.","family":"Kauling","sequence":"additional","affiliation":[{"name":"Department of Cardiology Erasmus MC, University Medical Center Rotterdam  Rotterdam the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marlies J. E.","family":"Kempers","sequence":"additional","affiliation":[{"name":"Department of Human Genetics Radboud University Nijmegen Medical Center  Nijmegen the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8672-4365","authenticated-orcid":false,"given":"Martijn A.","family":"Oudijk","sequence":"additional","affiliation":[{"name":"Department of Obstetrics, Amsterdam UMC Vrije Universiteit Amsterdam  Amsterdam the Netherlands"},{"name":"Amsterdam Reproduction and Development Research Institute Amsterdam UMC, Vrije Universiteit Amsterdam  Amsterdam the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alessandra","family":"Maugeri","sequence":"additional","affiliation":[{"name":"Department of Human Genetics, Amsterdam UMC Vrije Universiteit Amsterdam  Amsterdam the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hennie T.","family":"Br\u00fcggenwirth","sequence":"additional","affiliation":[{"name":"Department of Clinical Genetics, Erasmus MC University Medical Center  Rotterdam the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arjan C.","family":"Houweling","sequence":"additional","affiliation":[{"name":"Department of Human Genetics, Amsterdam UMC Vrije Universiteit Amsterdam  Amsterdam the Netherlands"},{"name":"Department of Human Genetics, Amsterdam UMC University of Amsterdam  Amsterdam the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Serwet","family":"Demirdas","sequence":"additional","affiliation":[{"name":"Department of Clinical Genetics, Erasmus MC University Medical Center  Rotterdam the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,3,19]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1038\/ejhg.2015.32"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM200003093421001"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1097\/GIM.0b013e3182180c89"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1038\/gim.2014.72"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1002\/ajmg.c.31553"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1038\/gim.2014.53"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2665-9913(21)00214-9"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijscr.2022.106840"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(83)91577-5"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/0028-2243(89)90214-1"},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41431\u2010023\u201001343\u20107"},{"key":"e_1_2_11_13_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCGEN.122.003978"},{"key":"e_1_2_11_14_1","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehy340"},{"key":"e_1_2_11_15_1","doi-asserted-by":"publisher","DOI":"10.1080\/01443619867416"},{"key":"e_1_2_11_16_1","doi-asserted-by":"publisher","DOI":"10.1159\/000109218"},{"key":"e_1_2_11_17_1","doi-asserted-by":"publisher","DOI":"10.1002\/ajmg.a.38033"},{"key":"e_1_2_11_18_1","unstructured":"B. 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