{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,9]],"date-time":"2026-04-09T05:44:12Z","timestamp":1775713452614,"version":"3.50.1"},"reference-count":28,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2026,1,22]],"date-time":"2026-01-22T00:00:00Z","timestamp":1769040000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,1,22]],"date-time":"2026-01-22T00:00:00Z","timestamp":1769040000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["BJOG"],"published-print":{"date-parts":[[2026,4]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To assess risk markers for short\u2010term major adverse cardiovascular events (MACE) following postpartum haemorrhage (PPH).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>A retrospective cohort study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>Five study sites across the US, Canada, the Netherlands and Colombia.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Population<\/jats:title>\n                    <jats:p>Individuals with PPH in 2012\u20132017.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Main Outcome Measures<\/jats:title>\n                    <jats:p>MACE (including acute myocardial infarction, pulmonary oedema, cardiomyopathy, stroke, and cardiac death) observed during a hospitalisation for birth.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We compared characteristics and therapeutic interventions (as indicators of severe bleeding) among participants with and without MACE. We conducted an exploratory analysis using multivariable logistic regression to identify risk markers for MACE.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Two thousand and sixty\u2010nine participants had PPH (US:\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u20091055, Canada:\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u2009613, the Netherlands:\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u2009302, Colombia:\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200999), of whom 40 (1.93%, 95% CI [1.38, 2.62]) experienced MACE. Pulmonary oedema was the most common type of event (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200937, 1.79%, 95% CI [1.26\u20132.46]). Participants with MACE had more preeclampsia (30% vs. 9.91%) and heart disease (7.50% vs. 1.38%) than those without (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.05). MACE occurred more frequently in the context of infections (adjusted odds ratio [aOR] 6.81, 95% CI [3.24\u201314.33]), aspirin use (aOR 4.49, 95% CI [1.07\u201318.85]), and markers of severe bleeding, such as the need for prostaglandin F2 alpha analogues (aOR 3.16, 95% CI [1.41\u20137.07]) and blood products (aOR 3.08, 95% CI [1.41\u20136.71]). A higher antenatal haemoglobin was associated with less MACE (aOR 0.96, 95% CI [0.94\u20130.98]).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>About 2 in 100 persons with PPH developed MACE, mostly pulmonary oedema. Risk markers identified individuals with PPH who may require increased monitoring. Whether treating anaemia can prevent cardiovascular morbidity following PPH must be evaluated.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/1471-0528.70130","type":"journal-article","created":{"date-parts":[[2026,1,23]],"date-time":"2026-01-23T06:04:31Z","timestamp":1769148271000},"page":"1006-1015","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Short\u2010Term Major Adverse Cardiovascular Events Following Postpartum Haemorrhage: A Cohort Study (The\n                    <scp>MACEPH<\/scp>\n                    Study)"],"prefix":"10.1111","volume":"133","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9140-8735","authenticated-orcid":false,"given":"Isabelle","family":"Malham\u00e9","sequence":"first","affiliation":[{"name":"Department of Medicine McGill University Health Centre  Montreal Qu\u00e9bec Canada"},{"name":"Department of Medicine Women &amp; Infants Hospital  Providence Rhode Island USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Robin","family":"Campen","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Leiden University Medical Center  Leiden the Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mara","family":"Bensson","sequence":"additional","affiliation":[{"name":"Department of Medicine Women &amp; Infants Hospital  Providence Rhode Island USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Clarissa","family":"Andre","sequence":"additional","affiliation":[{"name":"Department of Medicine Women &amp; Infants Hospital  Providence Rhode Island USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sarah","family":"Dominguez","sequence":"additional","affiliation":[{"name":"Department of Medicine Women &amp; Infants Hospital  Providence Rhode Island USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sally","family":"Twin","sequence":"additional","affiliation":[{"name":"Interdepartmental Division of Critical Care Medicine University of Toronto  Toronto Ontario Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ambreen","family":"Syeda","sequence":"additional","affiliation":[{"name":"Department of Obstetrics &amp; Gynaecology Mount Sinai Hospital  Toronto Ontario Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rizwana","family":"Ashraf","sequence":"additional","affiliation":[{"name":"Department of Obstetrics &amp; Gynaecology Mount Sinai Hospital  Toronto Ontario Canada"},{"name":"Department of Obstetrics &amp; Gynecology and Department of Health Research Methods, Evidence and Impact Hamilton Health Sciences  Hamilton Ontario Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Angel","family":"Vasquez","sequence":"additional","affiliation":[{"name":"Intensive Care and Obstetric Research Group (GRICIO) Universidad de Cartagena  Cartagena Colombia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yoliana","family":"Guardo","sequence":"additional","affiliation":[{"name":"Intensive Care and Obstetric Research Group (GRICIO) Universidad de Cartagena  Cartagena Colombia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4090-1597","authenticated-orcid":false,"given":"Carlos","family":"Lopez","sequence":"additional","affiliation":[{"name":"Intensive Care and Obstetric Research Group (GRICIO) Universidad de Cartagena  Cartagena Colombia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Byron","family":"Rosero\u2010Britton","sequence":"additional","affiliation":[{"name":"Intensive Care and Obstetric Research Group (GRICIO) Universidad de Cartagena  Cartagena Colombia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hannah","family":"Spalding","sequence":"additional","affiliation":[{"name":"Department of Medicine Women &amp; Infants Hospital  Providence Rhode Island USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kristen","family":"Petagna","sequence":"additional","affiliation":[{"name":"Department of Medicine Women &amp; Infants Hospital  Providence Rhode Island USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Grace","family":"DeCost","sequence":"additional","affiliation":[{"name":"Department of Medicine Women &amp; Infants Hospital  Providence Rhode Island USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Benjamin A.","family":"Bouvier","sequence":"additional","affiliation":[{"name":"Department of Medicine Women &amp; Infants Hospital  Providence Rhode Island USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"A. Kinga","family":"Malinowski","sequence":"additional","affiliation":[{"name":"Department of Obstetrics &amp; Gynaecology Mount Sinai Hospital  Toronto Ontario Canada"},{"name":"Lunenfeld\u2010Tanenbaum Research Institute Mount Sinai Hospital  Toronto Ontario Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"James","family":"O'Brien","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Warren Alpert Medical School of Brown University Women &amp; Infants Hospital  Providence Rhode Island USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Valery A.","family":"Danilack\u2010Fekete","sequence":"additional","affiliation":[{"name":"Yale University\/Yale New Haven Health System Center for Outcomes Research and Evaluation (CORE)  New Haven Connecticut USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christina A.","family":"Raker","sequence":"additional","affiliation":[{"name":"Lifespan Biostatistics, Epidemiology, Research Design, and Informatics Lifespan Health System\/Rhode Island Hospital  Providence Rhode Island USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rohan","family":"D'Souza","sequence":"additional","affiliation":[{"name":"Department of Obstetrics &amp; Gynaecology Mount Sinai Hospital  Toronto Ontario Canada"},{"name":"Department of Obstetrics &amp; Gynecology and Department of Health Research Methods, Evidence and Impact Hamilton Health Sciences  Hamilton Ontario Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jose","family":"Rojas\u2010Suarez","sequence":"additional","affiliation":[{"name":"Intensive Care and Obstetric Research Group (GRICIO) Universidad de Cartagena  Cartagena Colombia"},{"name":"School of GINUMED Research Group Corporaci\u00f3n Universitaria Rafael N\u00fa\u00f1ez  Cartagena Colombia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Thomas","family":"van den Akker","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Leiden University Medical Center  Leiden the Netherlands"},{"name":"Athena Institute VU University  Amsterdam the Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stephen E.","family":"Lapinsky","sequence":"additional","affiliation":[{"name":"Department of Obstetrics &amp; Gynaecology Mount Sinai Hospital  Toronto Ontario Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7601-2214","authenticated-orcid":false,"given":"Kenneth K.","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Medicine Women &amp; Infants Hospital  Providence Rhode Island USA"},{"name":"Department of Medicine Beth Israel Deacones Medical Center  Boston Massachusetts USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2026,1,22]]},"reference":[{"key":"e_1_2_12_2_1","volume-title":"WHO Recommendations for the Prevention and Treatment of Postpartum Haemorrhage","author":"WHO Guidelines Approved by the Guidelines Review Committee","year":"2012"},{"key":"e_1_2_12_3_1","unstructured":"K. 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