{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T01:59:47Z","timestamp":1788919187310,"version":"build-2803163510"},"reference-count":30,"publisher":"BMJ","issue":"20","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Heart"],"accepted":{"date-parts":[[2010,7,19]]},"published-print":{"date-parts":[[2010,10,15]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Women with congenital heart disease (CHD) are at risk for adverse cardiac events during pregnancy; however, the risk of events late after pregnancy (late cardiac events; LCE) has not been well studied. A study was undertaken to examine the frequency and determinants of LCE in a large cohort of women with CHD.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Baseline characteristics and pregnancy were prospectively recorded. LCE (&gt;6\u2005months after delivery) were determined by chart review. Survival analysis was used to determine the risk factors for LCE.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>A tertiary care referral hospital.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Patients<\/jats:title>\n                    <jats:p>The outcomes of 405 pregnancies were studied (318 women; median follow-up 2.6\u2005years).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Main outcome measures<\/jats:title>\n                    <jats:p>LCE included cardiac death\/arrest, pulmonary oedema, arrhythmia or stroke.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>LCE occurred after 12% (50\/405) of pregnancies. The 5-year rate of LCE was higher in women with adverse cardiac events during pregnancy than in those without (27\u00b19% vs 15\u00b13%, HR 2.2, p=0.02). Women at highest risk for LCE were those with functional limitations\/cyanosis (HR 3.9, 95% CI 1.2 to 13.0), subaortic ventricular dysfunction (HR 3.0, 95% CI 1.4 to 6.6), subpulmonary ventricular dysfunction and\/or significant pulmonary regurgitation (HR 3.2, 95% CI 1.6 to 6.6), left heart obstruction (HR 2.6, 95% CI 1.2 to 5.2) and cardiac events before or during pregnancy (HR 2.6, 95% CI 1.3 to 4.9). In women with 0, 1 or &gt;1 risk predictors the 5-year rate of LCE was 7\u00b12%, 23\u00b15% and 44\u00b110%, respectively (p&lt;0.001).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>In women with CHD, pre-pregnancy maternal characteristics can help to identify women at increased risk for LCE. Adverse cardiac events during pregnancy are important and are associated with an increased risk of LCE.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/hrt.2010.202838","type":"journal-article","created":{"date-parts":[[2010,10,11]],"date-time":"2010-10-11T11:44:19Z","timestamp":1286797459000},"page":"1656-1661","source":"Crossref","is-referenced-by-count":107,"title":["Cardiac outcomes after pregnancy in women with congenital heart disease"],"prefix":"10.1136","volume":"96","author":[{"given":"Olga H","family":"Balint","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samuel 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