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This study examined trends in prevalence of cardiovascular disease and its association with maternal and perinatal outcomes, overall and by timing of diagnosis in relation to pregnancy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Material and Methods<\/jats:title><jats:p>This population\u2010based observational retrospective cohort study consisted of women aged 15\u201349\u2009years who were registered in the Swedish Medical Birth Register 2000\u20132019. Prevalence was defined as annual diagnosis of cardiovascular disease per pregnant woman as numerator and all pregnant women per year as denominator. Adverse maternal and perinatal outcomes were analyzed using time\u2010dependent Cox regression and Poisson regression models. Outcomes were obtained during and after childbirth up to 1\u2009year postpartum, depending on the outcome.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>There were 2\u2009069\u2009107 births to 1\u2009186\u2009137 women (911\u2009101 primiparous). The prevalence of cardiovascular disease among pregnant women in Sweden during 2000\u20132019 increased from 0.31% to 1.34%, for non\u2010congenital cardiovascular disease, this was primarily driven by arrythmia (0.11%\u20130.58%). Primiparous women with cardiovascular disease had a higher risk of eclampsia over\u2010all (aHR 4.50, 95% CI 2.01\u201310.05) and when diagnosed during pregnancy (aHR 3.22, 95% CI 1.21\u20138.61); admission to psychiatric ward overall (aHR 2.51, 95% CI 1.30\u20134.83), and when diagnosed during pregnancy (aHR 2.54, 95% CI 1.21\u20135.34); and one\u2010year mortality when diagnosed before pregnancy (aHR 1.67, 95% CI 1.16\u20132.42) and when diagnosed postpartum (aHR 6.59, 95% CI 3.38\u201312.84), compared to those without cardiovascular disease. Children born to women with cardiovascular disease diagnosed both overall and in relation to timing of diagnosis had an increased risk of being born preterm and small for gestational age.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Cardiovascular disease prevalence among pregnant women in Sweden increased during 2000\u20132019, primarily driven by arrhythmias. In primiparous women, the timing of diagnosis of cardiovascular disease is important for maternal and perinatal outcomes, including when diagnosed postpartum. This calls for awareness among all staff when planning pregnancy and monitoring women with cardiovascular disease throughout pregnancy and in the postpartum period.<\/jats:p><\/jats:sec>","DOI":"10.1111\/aogs.14972","type":"journal-article","created":{"date-parts":[[2024,10,24]],"date-time":"2024-10-24T21:20:26Z","timestamp":1729804826000},"page":"2401-2411","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Cardiovascular disease in pregnancy: Prevalence and obstetric outcomes in a Swedish population\u2010based cohort study between 2000 and 2019"],"prefix":"10.1111","volume":"103","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1947-679X","authenticated-orcid":false,"given":"Teresia","family":"Svanvik","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynecology Institute of Clinical Sciences, University of Gothenburg  Gothenburg Sweden"},{"name":"National Perinatal Epidemiology Unit, Oxford Population Health University of Oxford  Oxford UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rema","family":"Ramakrishnan","sequence":"additional","affiliation":[{"name":"National Perinatal Epidemiology Unit, Oxford Population Health University of Oxford  Oxford UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martin","family":"Svensson","sequence":"additional","affiliation":[{"name":"Department of Mathematics and Computer Science, Faculty of Science University of Southern Denmark  Odense Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Henrik","family":"Albrektsson","sequence":"additional","affiliation":[{"name":"Statistiska Konsultgruppen  Gothenburg Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carmen","family":"Basic","sequence":"additional","affiliation":[{"name":"Department of Molecular and Clinical Medicine Institute of Medicine, University of Gothenburg  Gothenburg Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zacharias","family":"Mandalenakis","sequence":"additional","affiliation":[{"name":"Department of Molecular and Clinical Medicine Institute of Medicine, University of Gothenburg  Gothenburg Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Annika","family":"Rosengren","sequence":"additional","affiliation":[{"name":"Department of Molecular and Clinical Medicine Institute of Medicine, University of Gothenburg  Gothenburg Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria","family":"Schaufelberger","sequence":"additional","affiliation":[{"name":"Department of Molecular and Clinical Medicine Institute of Medicine, University of Gothenburg  Gothenburg Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erik","family":"Thunstr\u00f6m","sequence":"additional","affiliation":[{"name":"Department of Molecular and Clinical Medicine Institute of Medicine, University of Gothenburg  Gothenburg Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1984-4575","authenticated-orcid":false,"given":"Marian","family":"Knight","sequence":"additional","affiliation":[{"name":"Department of Molecular and Clinical Medicine Institute of Medicine, University of Gothenburg  Gothenburg Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,10,24]]},"reference":[{"key":"e_1_2_13_2_1","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehr218"},{"key":"e_1_2_13_3_1","first-page":"1","article-title":"M\u00f6drad\u00f6d i Sverige: V\u00e5rden hade m\u00e5nga g\u00e5nger kunnat vara b\u00e4ttre, L\u00e4rdomar fr\u00e5n 11 \u00e5rs extern kollegial granskning.[ Maternal death in Sweden: Care could have been better many times, Lessons from 11\u2009years of external peer review.] In Swedish","volume":"116","author":"Grundewald C","year":"2019","journal-title":"Lakartidningen"},{"key":"e_1_2_13_4_1","doi-asserted-by":"crossref","DOI":"10.1136\/bmj-2022-070621","article-title":"Maternal mortality in eight European countries with enhanced surveillance systems: descriptive population based study","volume":"379","author":"Diguisto C","year":"2022","journal-title":"BMJ"},{"key":"e_1_2_13_5_1","volume-title":"OECD Family Database","author":"OECD","year":"2024"},{"key":"e_1_2_13_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/chd.12811"},{"key":"e_1_2_13_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2213-8587(19)30026-9"},{"key":"e_1_2_13_8_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0201881"},{"key":"e_1_2_13_9_1","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehy340"},{"key":"e_1_2_13_10_1","first-page":"643","article-title":"Fetomaternal outcome of pregnancy with mitral stenosis. 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