{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,31]],"date-time":"2026-08-31T01:13:51Z","timestamp":1788138831148,"version":"build-2803163510"},"reference-count":49,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"21","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2019,11,5]]},"abstract":"<jats:sec xml:lang=\"en\">\n            <jats:title>Background<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              We hypothesized that women with congenital heart disease (\n              <jats:styled-content style=\"fixed-case\">CHD<\/jats:styled-content>\n              ) are at increased risk of giving birth preterm, including very and moderately preterm and giving birth to infants small for gestational age (\n              <jats:styled-content style=\"fixed-case\">SGA<\/jats:styled-content>\n              ). We aimed to investigate this in a nation\u2010wide study with focus on the potential modifying effect of socioeconomic status.\n            <\/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              We performed a cohort study using Danish nation\u2010wide registers between 1997 and 2014. The exposure, maternal\n              <jats:styled-content style=\"fixed-case\">CHD<\/jats:styled-content>\n              , was subdivided into simple, moderate and complex based on severity of defects. Outcomes were preterm birth and\n              <jats:styled-content style=\"fixed-case\">SGA<\/jats:styled-content>\n              . Cox regression was used to estimate hazard ratios (\n              <jats:styled-content style=\"fixed-case\">HR<\/jats:styled-content>\n              ). A total of 933\u00a0149 births including 3745 births among women with\n              <jats:styled-content style=\"fixed-case\">CHD<\/jats:styled-content>\n              were studied. The risk of giving birth preterm and\n              <jats:styled-content style=\"fixed-case\">SGA<\/jats:styled-content>\n              were higher among women with\n              <jats:styled-content style=\"fixed-case\">CHD<\/jats:styled-content>\n              as compared with women without\n              <jats:styled-content style=\"fixed-case\">CHD<\/jats:styled-content>\n              ; for example, adjusted hazard ratios of preterm birth according to severity: simple 1.33 (95%\n              <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>\n              , 1.11\u20131.59), moderate 1.45 (95%\n              <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>\n              , 1.14\u20131.83) and complex 3.26 (95%\n              <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>\n              , 2.41\u20134.40). Same pattern was seen for very and moderately preterm births and\n              <jats:styled-content style=\"fixed-case\">SGA<\/jats:styled-content>\n              . Education was a strong predictor of both preterm birth and\n              <jats:styled-content style=\"fixed-case\">SGA<\/jats:styled-content>\n              but did not modify the association between maternal congenital heart disease and preterm birth (\n              <jats:italic>P<\/jats:italic>\n              =0.38) or\n              <jats:styled-content style=\"fixed-case\">SGA<\/jats:styled-content>\n              (\n              <jats:italic>P<\/jats:italic>\n              =0.99).\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              Women with\n              <jats:styled-content style=\"fixed-case\">CHD<\/jats:styled-content>\n              were at increased risk of preterm birth both, moderately and very preterm, as well as giving birth to infants\n              <jats:styled-content style=\"fixed-case\">SGA<\/jats:styled-content>\n              . Education was a strong predictor of both preterm birth and\n              <jats:styled-content style=\"fixed-case\">SGA<\/jats:styled-content>\n              but the association between\n              <jats:styled-content style=\"fixed-case\">CHD<\/jats:styled-content>\n              and risk of preterm birth and\n              <jats:styled-content style=\"fixed-case\">SGA<\/jats:styled-content>\n              was independent of educational level.\n            <\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/jaha.119.013491","type":"journal-article","created":{"date-parts":[[2019,10,28]],"date-time":"2019-10-28T09:02:06Z","timestamp":1572253326000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":14,"title":["Neonatal Risk in Children of Women With Congenital Heart Disease: A\u00a0Cohort Study With Focus on Socioeconomic Status"],"prefix":"10.1161","volume":"8","author":[{"given":"Stine","family":"Kloster","sequence":"first","affiliation":[{"name":"The National Institute of Public Health University of Southern Denmark Copenhagen Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Janne S.","family":"Tolstrup","sequence":"additional","affiliation":[{"name":"The National Institute of Public Health University of Southern Denmark Copenhagen Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Morten Sm\u00e6rup","family":"Olsen","sequence":"additional","affiliation":[{"name":"Department of Radiology Aarhus University Hospital Aarhus Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S\u00f8ren Paaske","family":"Johnsen","sequence":"additional","affiliation":[{"name":"Department of Clinical MedicineAalborg University Aalborg Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lars","family":"S\u00f8ndergaard","sequence":"additional","affiliation":[{"name":"Department of Cardiology Rigshospitalet Copenhagen Denmark"},{"name":"University Hospital of Copenhagen Copenhagen Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dorte Guldbrand","family":"Nielsen","sequence":"additional","affiliation":[{"name":"Department of Clinical Medicine Aarhus University Aarhus Denmark"},{"name":"Department of Cardiology Aarhus University Hospital Aarhus Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Annette Kj\u00e6r","family":"Ersb\u00f8ll","sequence":"additional","affiliation":[{"name":"The National Institute of Public Health University of Southern Denmark Copenhagen Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2010.03.085"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.pcad.2018.08.004"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehs270"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1136\/heartjnl-2013-304888"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0000000000000973"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2007.03.027"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.3109\/14767058.2015.1085012"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jclinane.2015.04.006"},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.1161\/JAHA.118.009395"},{"key":"e_1_3_2_11_2","doi-asserted-by":"publisher","DOI":"10.1253\/circj.CJ-15-0572"},{"key":"e_1_3_2_12_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIR.0000000000000458"},{"key":"e_1_3_2_13_2","first-page":"391","article-title":"Birth weight in pregnancies complicated by maternal heart disease","volume":"105","author":"Cauldwell M","year":"2019","unstructured":"Cauldwell M, Steer P, Sterrenburg M, Wallace S, Malin G, Ulivi G, Everett T, Jakes AD, Head CEG, Mohan AR, Haynes S, Simpson M, Brennand J, Johnson MR. 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