{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T16:18:41Z","timestamp":1791562721787,"version":"4.3.4"},"reference-count":26,"publisher":"BMJ","issue":"1","license":[{"start":{"date-parts":[[2024,5,23]],"date-time":"2024-05-23T00:00:00Z","timestamp":1716422400000},"content-version":"unspecified","delay-in-days":22,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Swedish state under an agreement concerning research and education of doctors","award":["ALFGBG-725081"],"award-info":[{"award-number":["ALFGBG-725081"]}]},{"name":"Swedish state under an agreement concerning research and education of doctors","award":["ALFGBG-965397"],"award-info":[{"award-number":["ALFGBG-965397"]}]},{"name":"Swedish state under an agreement concerning research and education of doctors","award":["ALFGBG-966211"],"award-info":[{"award-number":["ALFGBG-966211"]}]},{"name":"Swedish Heart and Lung Foundation","award":["2018-0419"],"award-info":[{"award-number":["2018-0419"]}]},{"name":"Swedish Heart and Lung Foundation","award":["2020-0502"],"award-info":[{"award-number":["2020-0502"]}]},{"name":"Swedish Heart and Lung Foundation","award":["2021-0345"],"award-info":[{"award-number":["2021-0345"]}]},{"DOI":"10.13039\/501100004359","name":"Swedish Research Council","doi-asserted-by":"crossref","award":["2018-02527"],"award-info":[{"award-number":["2018-02527"]}],"id":[{"id":"10.13039\/501100004359","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/501100004359","name":"Swedish Research Council","doi-asserted-by":"crossref","award":["VRREG 2019-00193"],"award-info":[{"award-number":["VRREG 2019-00193"]}],"id":[{"id":"10.13039\/501100004359","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Open Heart"],"accepted":{"date-parts":[[2024,5,2]]},"published-print":{"date-parts":[[2024,5]]},"abstract":"<jats:sec>\n                  <jats:title>Background and aims<\/jats:title>\n                  <jats:p>Pre-eclampsia complicates 3\u20135% of pregnancies worldwide and is associated with adverse outcomes for the mother and the offspring. Pre-eclampsia and heart failure have common risk factors, including hypertension, obesity and diabetes. It is not known whether heart failure increases the risk of pre-eclampsia. This study examines whether pregestational heart failure increases the risk of pre-eclampsia.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>In a registry-based case\u2013cohort study that included all pregnancies in Sweden (n=3 125 527) between 1990 and 2019, all pregnancies with pre-eclampsia (n=90 354) were identified and up to five control pregnancies (n=451\u2009466) for each case were chosen, matched on the mother\u2019s birth year. Multiple logistic regression analysis was used to evaluate the impact of heart failure on the risk of pre-eclampsia, with adjustment for established risk factors and other cardiovascular diseases.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Women with heart failure had no increased risk for pre-eclampsia, OR 1.02 (95% CI 0.69 to 1.50). Women with valvular heart disease had an increased OR of preterm pre-eclampsia, with an adjusted OR of 1.78 (95% CI 1.04 to 3.06). Hypertension and diabetes were independent risk factors for pre-eclampsia. Obesity, multifetal pregnancies, in vitro fertilisation, older age, Nordic origin and nulliparity were more common among women who developed pre-eclampsia compared with controls.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>Women with heart failure do not have an increased risk of pre-eclampsia. However, women with valvular heart disease prior to pregnancy have an increased risk of developing preterm pre-eclampsia independent of other known risk factors.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/openhrt-2024-002728","type":"journal-article","created":{"date-parts":[[2024,5,23]],"date-time":"2024-05-23T12:50:55Z","timestamp":1716468655000},"page":"e002728","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":3,"title":["Heart disease in pregnancy and risk of pre-eclampsia: a Swedish register-based study"],"prefix":"10.1136","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9642-8404","authenticated-orcid":false,"given":"Karl","family":"Bergman","sequence":"first","affiliation":[{"name":"Department of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden"},{"name":"Division of Cardiology, Tygerberg Hospital, Stellenbosch University, Faculty of Medicine and Health Sciences, Cape Town, Western Cape, South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Teresia","family":"Svanvik","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, University of Gothenburg Institute of Clinical Sciences, G\u00f6teborg, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carmen","family":"Basic","sequence":"additional","affiliation":[{"name":"Department of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska Academy, 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, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tatiana","family":"Zverkova Sandstr\u00f6m","sequence":"additional","affiliation":[{"name":"Department of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jimmy","family":"Celind","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, University of Gothenburg Institute of Clinical Sciences, G\u00f6teborg, Sweden"},{"name":"Sahlgrenska Osteoporosis Centre, University of Gothenburg Institute of Medicine, G\u00f6teborg, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1013-542X","authenticated-orcid":false,"given":"Helen","family":"Sj\u00f6land","sequence":"additional","affiliation":[{"name":"Department of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna-Karin","family":"Wikstr\u00f6m","sequence":"additional","affiliation":[{"name":"Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0611-0863","authenticated-orcid":false,"given":"Maria","family":"Schaufelberger","sequence":"additional","affiliation":[{"name":"Department of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska Academy, 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, Sahlgrenska Academy, University of Gothenburg, Gothenburg, 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