{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,30]],"date-time":"2026-10-30T01:46:00Z","timestamp":1793324760797,"version":"4.5.0"},"reference-count":23,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"5","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Circulation"],"published-print":{"date-parts":[[2001,7,31]]},"abstract":"\n \n \n \n Background<\/jats:italic>\n <\/jats:bold>\n <\/jats:italic>\n <\/jats:bold>\n The maternal and neonatal risks associated with pregnancy in women with heart disease receiving comprehensive prenatal care have not been well defined.\n <\/jats:p>\n \n \n \n \n Methods and Results<\/jats:italic>\n <\/jats:bold>\n <\/jats:italic>\n <\/jats:bold>\n We prospectively enrolled 562 consecutive pregnant women with heart disease and determined the outcomes of 599 pregnancies not ending in miscarriage. Pulmonary edema, arrhythmia, stroke, or cardiac death complicated 13% of pregnancies. Prior cardiac events or arrhythmia, poor functional class or cyanosis, left heart obstruction, and left ventricular systolic dysfunction independently predicted maternal cardiac complications; the cardiac event rate can be predicted using a risk index incorporating these predictors. Neonatal complications (20% of pregnancies) were associated with poor functional class or cyanosis, left heart obstruction, anticoagulation, smoking, and multiple gestations.\n <\/jats:p>\n \n \n \n \n Conclusions<\/jats:italic>\n <\/jats:bold>\n <\/jats:italic>\n <\/jats:bold>\n Pregnancy in women with heart disease is associated with significant cardiac and neonatal complications, despite state-of-the-art obstetric and cardiac care. Maternal cardiac risk can be predicted with the use of a risk index.\n <\/jats:p>","DOI":"10.1161\/hc3001.093437","type":"journal-article","created":{"date-parts":[[2007,9,28]],"date-time":"2007-09-28T14:31:09Z","timestamp":1190989869000},"page":"515-521","update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":1137,"title":["Prospective Multicenter Study of Pregnancy Outcomes in Women With Heart Disease"],"prefix":"10.1161","volume":"104","author":[{"given":"Samuel C.","family":"Siu","sequence":"first","affiliation":[{"name":"From the University of Toronto (S.C.S., M.S., J.M.C., J.F.S., K.S.A., D.F., J.C.S., S.S.), Toronto, Ontario; University of Calgary (A.N.A.), Calgary, Alberta; University of Montreal (L.-A.M.), Montreal, Quebec; University of Ottawa (B.C.M.), Ottawa, Ontario; Dalhousie University (C.M.K.), Halifax, Nova Scotia; University of Western Ontario (M.L.B.), London, Ontario; University of British Columbia (M.C.K.), Vancouver, British Columbia; McGill University (F.M.), Montreal, Quebec; University of Alberta..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mathew","family":"Sermer","sequence":"additional","affiliation":[{"name":"From the University of Toronto (S.C.S., M.S., J.M.C., J.F.S., K.S.A., D.F., J.C.S., S.S.), Toronto, Ontario; University of Calgary (A.N.A.), Calgary, Alberta; University of Montreal (L.-A.M.), Montreal, Quebec; University of Ottawa (B.C.M.), Ottawa, Ontario; Dalhousie University (C.M.K.), Halifax, Nova Scotia; University of Western Ontario (M.L.B.), London, Ontario; University of British Columbia (M.C.K.), Vancouver, British Columbia; McGill University (F.M.), Montreal, Quebec; University of Alberta..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jack M.","family":"Colman","sequence":"additional","affiliation":[{"name":"From the University of Toronto (S.C.S., M.S., J.M.C., J.F.S., K.S.A., D.F., J.C.S., S.S.), Toronto, Ontario; University of Calgary (A.N.A.), Calgary, Alberta; University of Montreal (L.-A.M.), Montreal, Quebec; University of Ottawa (B.C.M.), Ottawa, Ontario; Dalhousie University (C.M.K.), Halifax, Nova Scotia; University of Western Ontario (M.L.B.), London, Ontario; University of British Columbia (M.C.K.), Vancouver, British Columbia; McGill University (F.M.), Montreal, Quebec; University of Alberta..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A. Nanette","family":"Alvarez","sequence":"additional","affiliation":[{"name":"From the University of Toronto (S.C.S., M.S., J.M.C., J.F.S., K.S.A., D.F., J.C.S., S.S.), Toronto, Ontario; University of Calgary (A.N.A.), Calgary, Alberta; University of Montreal (L.-A.M.), Montreal, Quebec; University of Ottawa (B.C.M.), Ottawa, Ontario; Dalhousie University (C.M.K.), Halifax, Nova Scotia; University of Western Ontario (M.L.B.), London, Ontario; University of British Columbia (M.C.K.), Vancouver, British Columbia; McGill University (F.M.), Montreal, Quebec; University of Alberta..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lise-Andree","family":"Mercier","sequence":"additional","affiliation":[{"name":"From the University of Toronto (S.C.S., M.S., J.M.C., J.F.S., K.S.A., D.F., J.C.S., S.S.), Toronto, Ontario; University of Calgary (A.N.A.), Calgary, Alberta; University of Montreal (L.-A.M.), Montreal, Quebec; University of Ottawa (B.C.M.), Ottawa, Ontario; Dalhousie University (C.M.K.), Halifax, Nova Scotia; University of Western Ontario (M.L.B.), London, Ontario; University of British Columbia (M.C.K.), Vancouver, British Columbia; McGill University (F.M.), Montreal, Quebec; University of Alberta..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brian C.","family":"Morton","sequence":"additional","affiliation":[{"name":"From the University of Toronto (S.C.S., M.S., J.M.C., J.F.S., K.S.A., D.F., J.C.S., S.S.), Toronto, Ontario; University of Calgary (A.N.A.), Calgary, Alberta; University of Montreal (L.-A.M.), Montreal, Quebec; University of Ottawa (B.C.M.), Ottawa, Ontario; Dalhousie University (C.M.K.), Halifax, Nova Scotia; University of Western Ontario (M.L.B.), London, Ontario; University of British Columbia (M.C.K.), Vancouver, British Columbia; McGill University (F.M.), Montreal, Quebec; University of Alberta..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Catherine M.","family":"Kells","sequence":"additional","affiliation":[{"name":"From the University of Toronto (S.C.S., M.S., J.M.C., J.F.S., K.S.A., D.F., J.C.S., S.S.), Toronto, Ontario; University of Calgary (A.N.A.), Calgary, Alberta; University of Montreal (L.-A.M.), Montreal, Quebec; University of Ottawa (B.C.M.), Ottawa, Ontario; Dalhousie University (C.M.K.), Halifax, Nova Scotia; University of Western Ontario (M.L.B.), London, Ontario; University of British Columbia (M.C.K.), Vancouver, British Columbia; McGill University (F.M.), Montreal, Quebec; University of Alberta..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M. Lynn","family":"Bergin","sequence":"additional","affiliation":[{"name":"From the University of Toronto (S.C.S., M.S., J.M.C., J.F.S., K.S.A., D.F., J.C.S., S.S.), Toronto, Ontario; University of Calgary (A.N.A.), Calgary, Alberta; University of Montreal (L.-A.M.), Montreal, Quebec; University of Ottawa (B.C.M.), Ottawa, Ontario; Dalhousie University (C.M.K.), Halifax, Nova Scotia; University of Western Ontario (M.L.B.), London, Ontario; University of British Columbia (M.C.K.), Vancouver, British Columbia; McGill University (F.M.), Montreal, Quebec; University of Alberta..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marla C.","family":"Kiess","sequence":"additional","affiliation":[{"name":"From the University of Toronto (S.C.S., M.S., J.M.C., J.F.S., K.S.A., D.F., J.C.S., S.S.), Toronto, Ontario; University of Calgary (A.N.A.), Calgary, Alberta; University of Montreal (L.-A.M.), Montreal, Quebec; University of Ottawa (B.C.M.), Ottawa, Ontario; Dalhousie University (C.M.K.), Halifax, Nova Scotia; University of Western Ontario (M.L.B.), London, Ontario; University of British Columbia (M.C.K.), Vancouver, British Columbia; McGill University (F.M.), Montreal, Quebec; University of Alberta..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francois","family":"Marcotte","sequence":"additional","affiliation":[{"name":"From the University of Toronto (S.C.S., M.S., J.M.C., J.F.S., K.S.A., D.F., J.C.S., S.S.), Toronto, Ontario; University of Calgary (A.N.A.), Calgary, Alberta; University of Montreal (L.-A.M.), Montreal, Quebec; University of Ottawa (B.C.M.), Ottawa, Ontario; Dalhousie University (C.M.K.), Halifax, Nova Scotia; University of Western Ontario (M.L.B.), London, Ontario; University of British Columbia (M.C.K.), Vancouver, British Columbia; McGill University (F.M.), Montreal, Quebec; University of Alberta..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dylan A.","family":"Taylor","sequence":"additional","affiliation":[{"name":"From the University of Toronto (S.C.S., M.S., J.M.C., J.F.S., K.S.A., D.F., J.C.S., S.S.), Toronto, Ontario; University of Calgary (A.N.A.), Calgary, Alberta; University of Montreal (L.-A.M.), Montreal, Quebec; University of Ottawa (B.C.M.), Ottawa, Ontario; Dalhousie University (C.M.K.), Halifax, Nova Scotia; University of Western Ontario (M.L.B.), London, Ontario; University of British Columbia (M.C.K.), Vancouver, British Columbia; McGill University (F.M.), Montreal, Quebec; University of Alberta..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elaine P.","family":"Gordon","sequence":"additional","affiliation":[{"name":"From the University of Toronto (S.C.S., M.S., J.M.C., J.F.S., K.S.A., D.F., J.C.S., S.S.), Toronto, Ontario; University of Calgary (A.N.A.), Calgary, Alberta; University of Montreal (L.-A.M.), Montreal, Quebec; University of Ottawa (B.C.M.), Ottawa, Ontario; Dalhousie University (C.M.K.), Halifax, Nova Scotia; University of Western Ontario (M.L.B.), London, Ontario; University of British Columbia (M.C.K.), Vancouver, British Columbia; McGill University (F.M.), Montreal, Quebec; University of Alberta..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John C.","family":"Spears","sequence":"additional","affiliation":[{"name":"From the University of Toronto (S.C.S., M.S., J.M.C., J.F.S., K.S.A., D.F., J.C.S., S.S.), Toronto, Ontario; University of Calgary (A.N.A.), Calgary, Alberta; University of Montreal (L.-A.M.), Montreal, Quebec; University of Ottawa (B.C.M.), Ottawa, Ontario; Dalhousie University (C.M.K.), Halifax, Nova Scotia; University of Western Ontario (M.L.B.), London, Ontario; University of British Columbia (M.C.K.), Vancouver, British Columbia; McGill University (F.M.), Montreal, Quebec; University of Alberta..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James W.","family":"Tam","sequence":"additional","affiliation":[{"name":"From the University of Toronto (S.C.S., M.S., J.M.C., J.F.S., K.S.A., D.F., J.C.S., S.S.), Toronto, Ontario; University of Calgary (A.N.A.), Calgary, Alberta; University of Montreal (L.-A.M.), Montreal, Quebec; University of Ottawa (B.C.M.), Ottawa, Ontario; Dalhousie University (C.M.K.), Halifax, Nova Scotia; University of Western Ontario (M.L.B.), London, Ontario; University of British Columbia (M.C.K.), Vancouver, British Columbia; McGill University (F.M.), Montreal, Quebec; University of Alberta..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kofi S.","family":"Amankwah","sequence":"additional","affiliation":[{"name":"From the University of Toronto (S.C.S., M.S., J.M.C., J.F.S., K.S.A., D.F., J.C.S., S.S.), Toronto, Ontario; University of Calgary (A.N.A.), Calgary, Alberta; University of Montreal (L.-A.M.), Montreal, Quebec; University of Ottawa (B.C.M.), Ottawa, Ontario; Dalhousie University (C.M.K.), Halifax, Nova Scotia; University of Western Ontario (M.L.B.), London, Ontario; University of British Columbia (M.C.K.), Vancouver, British Columbia; McGill University (F.M.), Montreal, Quebec; University of Alberta..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeffrey F.","family":"Smallhorn","sequence":"additional","affiliation":[{"name":"From the University of Toronto (S.C.S., M.S., J.M.C., J.F.S., K.S.A., D.F., J.C.S., S.S.), Toronto, Ontario; University of Calgary (A.N.A.), Calgary, Alberta; University of Montreal (L.-A.M.), Montreal, Quebec; University of Ottawa (B.C.M.), Ottawa, Ontario; Dalhousie University (C.M.K.), Halifax, Nova Scotia; University of Western Ontario (M.L.B.), London, Ontario; University of British Columbia (M.C.K.), Vancouver, British Columbia; McGill University (F.M.), Montreal, Quebec; University of Alberta..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dan","family":"Farine","sequence":"additional","affiliation":[{"name":"From the University of Toronto (S.C.S., M.S., J.M.C., J.F.S., K.S.A., D.F., J.C.S., S.S.), Toronto, Ontario; University of Calgary (A.N.A.), Calgary, Alberta; University of Montreal (L.-A.M.), Montreal, Quebec; University of Ottawa (B.C.M.), Ottawa, Ontario; Dalhousie University (C.M.K.), Halifax, Nova Scotia; University of Western Ontario (M.L.B.), London, Ontario; University of British Columbia (M.C.K.), Vancouver, British Columbia; McGill University (F.M.), Montreal, Quebec; 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