{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,14]],"date-time":"2026-03-14T17:41:15Z","timestamp":1773510075826,"version":"3.50.1"},"reference-count":49,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"3","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2014,5,22]]},"abstract":"<jats:sec xml:lang=\"en\">\n            <jats:title>Background<\/jats:title>\n            <jats:p xml:lang=\"en\">As the prognosis of women with prosthetic heart valves improves, and increasing number are contemplating and undertaking pregnancy. Accurate knowledge of perinatal outcomes is essential, assisting counseling and guiding care. The aims of this study were to assess outcomes in a contemporary population of women with heart valve prostheses undertaking pregnancy and to compare outcomes for women with mechanical and bioprosthetic prostheses.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Methods and Results<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              Longitudinally linked population health data sets containing birth and hospital admissions data were obtained for all women giving birth in New South Wales, Australia, 2000\u20132011. This included information identifying presence of maternal prosthetic heart valve. Cardiovascular and birth outcomes were evaluated. Among 1\u00a0144\u00a0156 pregnancies, 136 involved women with a heart valve prosthesis (1 per 10\u00a0000). No maternal mortality was seen among these women, although the relative risk for an adverse event was higher than the general population, including severe maternal morbidity (139 versus 14 per 1000 births, rate ratio [\n              <jats:styled-content style=\"fixed-case\">RR<\/jats:styled-content>\n              ]=9.96, 95%\n              <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>\n              6.32 to 15.7), major maternal cardiovascular event (44 versus 1 per 1000,\n              <jats:styled-content style=\"fixed-case\">RR<\/jats:styled-content>\n              34.6, 95%\n              <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>\n              14.6 to 81.6), preterm birth (183 versus 66 per 1000,\n              <jats:styled-content style=\"fixed-case\">RR<\/jats:styled-content>\n              =2.77, 95%\n              <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>\n              1.88 to 4.07), and small\u2010for\u2010gestational\u2010age infants (193 versus 95 per 1000,\n              <jats:styled-content style=\"fixed-case\">RR<\/jats:styled-content>\n              =2.03, 95%\n              <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>\n              1.40 to 2.96). There was a trend toward increased maternal and perinatal morbidity in women with a mechanical valve compared with those with a bioprosthetic valve.\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p xml:lang=\"en\">Pregnancies in women with a prosthetic heart valve demonstrate an increased risk of an adverse outcome, for both mothers and infants, compared with pregnancies in the absence of heart valve prostheses. In this contemporary population, the risk was lower than previously reported.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/jaha.114.000953","type":"journal-article","created":{"date-parts":[[2014,6,27]],"date-time":"2014-06-27T04:14:01Z","timestamp":1403842441000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":18,"title":["Heart Valve Prostheses in Pregnancy: Outcomes for Women and Their Infants"],"prefix":"10.1161","volume":"3","author":[{"given":"Claire M.","family":"Lawley","sequence":"first","affiliation":[{"name":"Clinical Population Perinatal Health Research, Kolling Institute, University of Sydney, Sydney, Australia"},{"name":"Department of Cardiology, Royal North Shore Hospital, St Leonards, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Charles S.","family":"Algert","sequence":"additional","affiliation":[{"name":"Clinical Population Perinatal Health Research, Kolling Institute, University of Sydney, Sydney, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jane B.","family":"Ford","sequence":"additional","affiliation":[{"name":"Clinical Population Perinatal Health Research, Kolling Institute, University of Sydney, Sydney, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tanya A.","family":"Nippita","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology, Royal North Shore Hospital, St Leonards, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gemma A.","family":"Figtree","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Royal North Shore Hospital, St Leonards, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christine L.","family":"Roberts","sequence":"additional","affiliation":[{"name":"Clinical Population Perinatal Health Research, Kolling Institute, University of Sydney, Sydney, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"276","reference":[{"key":"e_1_3_4_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2013.01.005"},{"key":"e_1_3_4_3_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.106.627224"},{"key":"e_1_3_4_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2010.03.085"},{"key":"e_1_3_4_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejcts.2004.12.002"},{"key":"e_1_3_4_6_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00404-011-2137-x"},{"key":"e_1_3_4_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/S1521-6926(03)00021-5"},{"key":"e_1_3_4_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0029-7844(97)85765-1"},{"key":"e_1_3_4_9_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijcard.2003.10.028"},{"key":"e_1_3_4_10_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.95.10.2407"},{"key":"e_1_3_4_11_2","doi-asserted-by":"publisher","DOI":"10.1161\/hc3001.093437"},{"key":"e_1_3_4_12_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2008.10.014"},{"key":"e_1_3_4_13_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1471-0528.2012.03359.x"},{"key":"e_1_3_4_14_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjcard.2009.06.040"},{"key":"e_1_3_4_15_2","doi-asserted-by":"publisher","DOI":"10.3324\/haematol.2008.002840"},{"key":"e_1_3_4_16_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0049-3848(11)70016-0"},{"key":"e_1_3_4_17_2","doi-asserted-by":"publisher","DOI":"10.1038\/nrcardio.2012.69"},{"key":"e_1_3_4_18_2","doi-asserted-by":"publisher","DOI":"10.1001\/archinte.160.2.191"},{"key":"e_1_3_4_19_2","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehr218"},{"key":"e_1_3_4_20_2","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehs109"},{"key":"e_1_3_4_21_2","unstructured":"ABS . Births Australia 2011. 2013."},{"key":"e_1_3_4_22_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1467-842X.2002.tb00682.x"},{"key":"e_1_3_4_23_2","doi-asserted-by":"publisher","DOI":"10.1002\/sim.4780140510"},{"key":"e_1_3_4_24_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jclinepi.2006.11.021"},{"key":"e_1_3_4_25_2","doi-asserted-by":"publisher","DOI":"10.1097\/MLR.0b013e318178eae4"},{"key":"e_1_3_4_26_2","doi-asserted-by":"publisher","DOI":"10.5694\/j.1326-5377.1999.tb127678.x"},{"key":"e_1_3_4_27_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-3016.2008.00980.x"},{"key":"e_1_3_4_28_2","doi-asserted-by":"publisher","DOI":"10.1071\/NB00045"},{"key":"e_1_3_4_29_2","doi-asserted-by":"publisher","DOI":"10.1080\/10641950701826695"},{"key":"e_1_3_4_30_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.thromres.2008.12.005"},{"key":"e_1_3_4_31_2","first-page":"448","article-title":"Pregnancy with prosthetic heart valves\u201430\u00a0years\u2019 nationwide experience in Denmark","volume":"40","author":"Sillesen M","year":"2011","unstructured":"Sillesen M, Hjortdal V, Vejlstrup N, Sorensen K. Pregnancy with prosthetic heart valves\u201430\u00a0years\u2019 nationwide experience in Denmark. Eur J Cardiothorac Surg. 2011;40:448\u2013454.","journal-title":"Eur J Cardiothorac Surg"},{"key":"e_1_3_4_32_2","doi-asserted-by":"publisher","DOI":"10.5694\/j.1326-5377.1988.tb104470.x"},{"key":"e_1_3_4_33_2","doi-asserted-by":"publisher","DOI":"10.5694\/j.1326-5377.1981.tb128315.x"},{"key":"e_1_3_4_34_2","first-page":"481","article-title":"Pregnancy has no effect on the rate of structural deterioration of bioprosthetic valves: long\u2010term 18\u2010year follow up results","volume":"14","author":"El Shaer F","year":"2005","unstructured":"El Shaer F, Hassan W, Latroche B, Helaly S, Hegazy H, Shahid M, Mohamed G, Al\u2010Halees Z. Pregnancy has no effect on the rate of structural deterioration of bioprosthetic valves: long\u2010term 18\u2010year follow up results. J Heart Valve Dis. 2005;14:481\u2013485.","journal-title":"J Heart Valve Dis"},{"key":"e_1_3_4_35_2","first-page":"864","article-title":"Influence of pregnancy after bioprosthetic valve replacement in young women: a prospective five\u2010year study","volume":"11","author":"Avila WS","year":"2002","unstructured":"Avila WS, Rossi EG, Grinberg M, Ramires JAF. Influence of pregnancy after bioprosthetic valve replacement in young women: a prospective five\u2010year study. J Heart Valve Dis. 2002;11:864\u2013869.","journal-title":"J Heart Valve Dis"},{"key":"e_1_3_4_36_2","doi-asserted-by":"publisher","DOI":"10.1016\/0003-4975(95)00308-8"},{"key":"e_1_3_4_37_2","doi-asserted-by":"publisher","DOI":"10.1016\/0003-4975(95)00253-H"},{"key":"e_1_3_4_38_2","doi-asserted-by":"publisher","DOI":"10.5830\/CVJA-2012-022"},{"key":"e_1_3_4_39_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2011.10.899"},{"key":"e_1_3_4_40_2","doi-asserted-by":"publisher","DOI":"10.1007\/s11748-005-0067-x"},{"key":"e_1_3_4_41_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1471-0528.2000.tb11696.x"},{"key":"e_1_3_4_42_2","doi-asserted-by":"publisher","DOI":"10.1136\/hrt.71.2.196"},{"key":"e_1_3_4_43_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjcard.2012.09.035"},{"key":"e_1_3_4_44_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2010.02.076"},{"key":"e_1_3_4_45_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2010.02.021"},{"key":"e_1_3_4_46_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.96.9.2789"},{"key":"e_1_3_4_47_2","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0b013e3182733d56"},{"key":"e_1_3_4_48_2","first-page":"353","article-title":"Pregnancy following cardiac prosthetic valve replacement","volume":"83","author":"Lee CN","year":"1994","unstructured":"Lee CN, Wu CC, Lin PY, Hsieh FJ, Chen HY. Pregnancy following cardiac prosthetic valve replacement. Obstet Gynecol. 1994;83:353\u2013356.","journal-title":"Obstet Gynecol"},{"key":"e_1_3_4_49_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijgo.2013.06.008"},{"key":"e_1_3_4_50_2","doi-asserted-by":"publisher","DOI":"10.1097\/01.mlr.0000228018.48783.34"}],"updated-by":[{"DOI":"10.1161\/jaha.114.000414","type":"correction","label":"Correction","source":"publisher","updated":{"date-parts":[[2014,8,15]],"date-time":"2014-08-15T00:00:00Z","timestamp":1408060800000}}],"container-title":["Journal of the American Heart Association"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ahajournals.org\/doi\/full\/10.1161\/JAHA.114.000953","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,5,13]],"date-time":"2024-05-13T10:28:21Z","timestamp":1715596101000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ahajournals.org\/doi\/10.1161\/JAHA.114.000953"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2014,5,22]]},"references-count":49,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2014,5,22]]}},"alternative-id":["10.1161\/JAHA.114.000953"],"URL":"https:\/\/doi.org\/10.1161\/jaha.114.000953","relation":{"correction":[{"id-type":"doi","id":"10.1161\/JAHA.114.000414","asserted-by":"object"}]},"ISSN":["2047-9980"],"issn-type":[{"value":"2047-9980","type":"electronic"}],"subject":[],"published":{"date-parts":[[2014,5,22]]},"assertion":[{"value":"2014-03-17","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2014-06-03","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2014-06-26","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e000953"}}