{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T17:32:03Z","timestamp":1792085523291,"version":"4.4.0"},"reference-count":36,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"7","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Circulation"],"published-print":{"date-parts":[[2016,8,16]]},"abstract":"<jats:sec>\n            <jats:title>Background:<\/jats:title>\n            <jats:p>Case series have described aortic dissection and rupture in pregnancy. Few population-based data exist to support an association.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods:<\/jats:title>\n            <jats:p>We performed a cohort-crossover study using data on all emergency department visits and acute care hospitalizations at nonfederal healthcare facilities in California, Florida, and New York. We included women \u226512 years of age with labor and delivery or abortive pregnancy outcome between 2005 and 2013. Our outcome was a composite of aortic dissection or rupture. Based on the timing of reported aortic complications during pregnancy, we defined the period of risk as 6 months before delivery until 3 months after delivery. We compared each patient\u2019s likelihood of aortic complications during this period with an equivalent 270-day period exactly 1 year later. Incidence rates and incidence rate ratios were computed using conditional Poisson regression with robust standard errors.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results:<\/jats:title>\n            <jats:p>Among 6\u2009566\u2009826 pregnancies in 4\u2009933\u2009697 women, we identified 36 cases of aortic dissection or rupture during the pregnancy or postpartum period and 9 cases during the control period 1 year later. The rate of aortic complications was 5.5 (95% confidence interval, 4.0\u20137.8) per million patients during pregnancy and the postpartum period, in comparison with 1.4 (95% confidence interval, 0.7\u20132.9) per million during the equivalent period 1 year later. Pregnancy was associated with a significantly increased risk of aortic dissection or rupture (incidence rate ratio, 4.0; 95% confidence interval, 2.0\u20138.2) in comparison with the control period 1 year later.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions:<\/jats:title>\n            <jats:p>The risk of aortic dissection or rupture is elevated during pregnancy and the postpartum period.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/circulationaha.116.021594","type":"journal-article","created":{"date-parts":[[2016,8,5]],"date-time":"2016-08-05T01:43:35Z","timestamp":1470361415000},"page":"527-533","update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":171,"title":["Pregnancy and the Risk of Aortic Dissection or Rupture"],"prefix":"10.1161","volume":"134","author":[{"given":"Hooman","family":"Kamel","sequence":"first","affiliation":[{"name":"From Department of Neurology (H.K.), Feil Family Brain and Mind Research Institute (H.K.), and Division of Cardiology M.J.R., R.B.D.), Weill Cornell Medicine, New York, NY; and Radcliffe Department of Medicine, Division of Cardiovascular Medicine, University of Oxford, Oxford, UK (A.P.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mary J.","family":"Roman","sequence":"additional","affiliation":[{"name":"From Department of Neurology (H.K.), Feil Family Brain and Mind Research Institute (H.K.), and Division of Cardiology M.J.R., R.B.D.), Weill Cornell Medicine, New York, NY; and Radcliffe Department of Medicine, Division of Cardiovascular Medicine, University of Oxford, Oxford, UK (A.P.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alex","family":"Pitcher","sequence":"additional","affiliation":[{"name":"From Department of Neurology (H.K.), Feil Family Brain and Mind Research Institute (H.K.), and Division of Cardiology M.J.R., R.B.D.), Weill Cornell Medicine, New York, NY; and Radcliffe Department of Medicine, Division of Cardiovascular Medicine, University of Oxford, Oxford, UK (A.P.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard B.","family":"Devereux","sequence":"additional","affiliation":[{"name":"From Department of Neurology (H.K.), Feil Family Brain and Mind Research Institute (H.K.), and Division of Cardiology M.J.R., R.B.D.), Weill Cornell Medicine, New York, NY; and Radcliffe Department of Medicine, Division of Cardiovascular Medicine, University of Oxford, Oxford, UK (A.P.)."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-143-10-200511150-00006"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.105.576751"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199609123351102"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1311485"},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.1097\/00000441-194512000-00003"},{"key":"e_1_3_3_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/0002-8703(58)90004-8"},{"key":"e_1_3_3_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(83)91577-5"},{"key":"e_1_3_3_9_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa055695"},{"key":"e_1_3_3_10_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM200003093421001"},{"key":"e_1_3_3_11_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.111.088633"},{"key":"e_1_3_3_12_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0003-4975(03)00169-3"},{"key":"e_1_3_3_13_2","first-page":"389","article-title":"Should pregnancy be considered a risk factor for aortic dissection? 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