{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T01:55:03Z","timestamp":1787018103141,"version":"build-2736575974"},"reference-count":98,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"14","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2021,7,20]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p xml:lang=\"en\">Heart failure (HF) remains the most common major cardiovascular complication arising in pregnancy and the postpartum period. Mothers who develop HF have been shown to experience an increased risk of death as well as a variety of adverse cardiac and obstetric outcomes. Recent studies have demonstrated that the risk to neonates is significant, with increased risks in perinatal morbidity and mortality, low Apgar scores, and prolonged neonatal intensive care unit stays. Information on the causal factors of HF can be used to predict risk and understand timing of onset, mortality, and morbidity. A variety of modifiable, nonmodifiable, and obstetric risk factors as well as comorbidities are known to increase a patient's likelihood of developing HF, and there are additional elements that are known to portend a poorer prognosis beyond the HF diagnosis. Multidisciplinary cardio\u2010obstetric teams are becoming more prominent, and their existence will both benefit patients through direct care and increased awareness and educate clinicians and trainees on this patient population. Detection, access to care, insurance barriers to extended postpartum follow\u2010up, and timely patient counseling are all areas where care for these women can be improved. Further data on maternal and fetal outcomes are necessary, with the formation of State Maternal Perinatal Quality Collaboratives paving the way for such advances.<\/jats:p>","DOI":"10.1161\/jaha.121.021019","type":"journal-article","created":{"date-parts":[[2021,7,14]],"date-time":"2021-07-14T05:08:19Z","timestamp":1626239299000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":49,"title":["Maternal Heart Failure"],"prefix":"10.1161","volume":"10","author":[{"given":"Rachel A.","family":"Bright","sequence":"first","affiliation":[{"name":"Division of Cardiovascular Medicine Department of Medicine State University of New YorkStony Brook University Medical CenterRenaissance School of Medicine Stony Brook NY"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fabio V.","family":"Lima","sequence":"additional","affiliation":[{"name":"Division of Cardiology Warren Alpert Medical School of Brown University and Lifespan Cardiovascular Institute Providence RI"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cecilia","family":"Avila","sequence":"additional","affiliation":[{"name":"Department of Obstetrics, Gynecology and Reproductive Medicine Stony Brook University Medical Center Stony Brook NY"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7683-4720","authenticated-orcid":false,"given":"Javed","family":"Butler","sequence":"additional","affiliation":[{"name":"Department of Medicine University of Mississippi Jackson MS"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7403-9029","authenticated-orcid":false,"given":"Kathleen","family":"Stergiopoulos","sequence":"additional","affiliation":[{"name":"St. Francis Hospital \u2013 The Heart Center\u00ae Roslyn NY"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_1_2_2","first-page":"1","article-title":"Mortality in the United States, 2018","volume":"355","author":"Xu J","year":"2020","unstructured":"Xu J, Murphy SL, Kockanek KD, Arias E. Mortality in the United States, 2018. NCHS Data Brief. 2020:355:1\u20138.","journal-title":"NCHS Data Brief"},{"key":"e_1_3_1_3_2","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0000000000001556"},{"key":"e_1_3_1_4_2","unstructured":"Centers for Disease Control . Pregnancy mortality surveillance system. 2020. Available at: https:\/\/www.cdc.gov\/reproductivehealth\/maternalinfanthealth\/pregnancy\u2010mortality\u2010surveillance\u2010system.htm?CDC_AA_refVal=https%3A%2F%2Fwww.cdc.gov%2Freproductivehealth%2Fmaternalinfanthealth%2Fpmss.html. Accessed January 2 2021."},{"key":"e_1_3_1_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjcard.2017.02.003"},{"key":"e_1_3_1_6_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCHEARTFAILURE.117.004005"},{"key":"e_1_3_1_7_2","doi-asserted-by":"publisher","DOI":"10.1136\/heartjnl-2013-304888"},{"key":"e_1_3_1_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2020.01.039"},{"key":"e_1_3_1_9_2","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehz136"},{"key":"e_1_3_1_10_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jchf.2014.10.008"},{"key":"e_1_3_1_11_2","doi-asserted-by":"publisher","DOI":"10.1136\/heartjnl-2018-313156"},{"key":"e_1_3_1_12_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.cardfail.2016.12.011"},{"key":"e_1_3_1_13_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCHEARTFAILURE.117.004134"},{"key":"e_1_3_1_14_2","doi-asserted-by":"publisher","DOI":"10.1097\/MD.0000000000008374"},{"key":"e_1_3_1_15_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2015.05.008"},{"key":"e_1_3_1_16_2","first-page":"H1060","article-title":"Serial study of factors influencing changes in cardiac output during human pregnancy","volume":"256","author":"Robson SC","year":"1989","unstructured":"Robson SC, Hunter S, Boys RJ, Dunlop W. Serial study of factors influencing changes in cardiac output during human pregnancy. Am J Physiol. 1989;256:H1060\u2013H1065. DOI: 10.1152\/ajpheart.1989.256.4.H1060.","journal-title":"Am J Physiol"},{"key":"e_1_3_1_17_2","doi-asserted-by":"publisher","DOI":"10.1136\/hrt.68.12.540"},{"key":"e_1_3_1_18_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1471-0528.1987.tb02286.x"},{"key":"e_1_3_1_19_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1471-0528.1996.tb09548.x"},{"key":"e_1_3_1_20_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijcard.2016.11.111"},{"key":"e_1_3_1_21_2","doi-asserted-by":"publisher","DOI":"10.1161\/circimaging.111.970012"},{"key":"e_1_3_1_22_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ccl.2012.05.004"},{"key":"e_1_3_1_23_2","doi-asserted-by":"publisher","DOI":"10.1053\/j.jvca.2019.12.021"},{"key":"e_1_3_1_24_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.295.6607.1169"},{"key":"e_1_3_1_25_2","doi-asserted-by":"publisher","DOI":"10.1136\/heartjnl-2015-308476"},{"key":"e_1_3_1_26_2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0197748"},{"key":"e_1_3_1_27_2","doi-asserted-by":"publisher","DOI":"10.1161\/JAHA.114.001056"},{"key":"e_1_3_1_28_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjcard.2006.01.039"},{"key":"e_1_3_1_29_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjcard.2019.03.012"},{"key":"e_1_3_1_30_2","doi-asserted-by":"publisher","DOI":"10.1161\/JAHA.118.009395"},{"key":"e_1_3_1_31_2","doi-asserted-by":"publisher","DOI":"10.1161\/JAHA.117.006144"},{"key":"e_1_3_1_32_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIR.0000000000000458"},{"key":"e_1_3_1_33_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.117.032561"},{"key":"e_1_3_1_34_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jchf.2019.09.001"},{"key":"e_1_3_1_35_2","doi-asserted-by":"publisher","DOI":"10.2459\/JCM.0000000000000222"},{"key":"e_1_3_1_36_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2018.02.076"},{"key":"e_1_3_1_37_2","doi-asserted-by":"publisher","DOI":"10.1002\/ejhf.501"},{"key":"e_1_3_1_38_2","doi-asserted-by":"publisher","DOI":"10.1097\/GCO.0b013e32834cb7a4"},{"key":"e_1_3_1_39_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2018.04.048"},{"key":"e_1_3_1_40_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjcard.2007.02.092"},{"key":"e_1_3_1_41_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2013.08.717"},{"key":"e_1_3_1_42_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.115.020491"},{"key":"e_1_3_1_43_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2015.06.1309"},{"key":"e_1_3_1_44_2","doi-asserted-by":"publisher","DOI":"10.1515\/jpm-2014-0086"},{"key":"e_1_3_1_45_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.acvd.2018.10.002"},{"key":"e_1_3_1_46_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjcard.2016.04.040"},{"key":"e_1_3_1_47_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12884-018-2169-3"},{"key":"e_1_3_1_48_2","doi-asserted-by":"publisher","DOI":"10.1161\/hc3001.093437"},{"key":"e_1_3_1_49_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.0000015699.48605.08"},{"key":"e_1_3_1_50_2","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehq200"},{"key":"e_1_3_1_51_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjcard.2015.04.063"},{"key":"e_1_3_1_52_2","doi-asserted-by":"publisher","DOI":"10.1111\/1471-0528.13491"},{"key":"e_1_3_1_53_2","doi-asserted-by":"publisher","DOI":"10.1161\/JAHA.115.002414"},{"key":"e_1_3_1_54_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjcard.2016.02.045"},{"key":"e_1_3_1_55_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2019.3667"},{"key":"e_1_3_1_56_2","doi-asserted-by":"publisher","DOI":"10.15420\/cfr.2015:24:2"},{"key":"e_1_3_1_57_2","doi-asserted-by":"publisher","DOI":"10.2147\/IJGM.S42326"},{"key":"e_1_3_1_58_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2018.09.035"},{"key":"e_1_3_1_59_2","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0000000000003243"},{"key":"e_1_3_1_60_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2004.12.006"},{"key":"e_1_3_1_61_2","doi-asserted-by":"publisher","DOI":"10.1002\/clc.20391"},{"key":"e_1_3_1_62_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2010.02.076"},{"key":"e_1_3_1_63_2","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0000000000003419"},{"key":"e_1_3_1_64_2","unstructured":"Gunja MZ Tikkanen R Seervai S Collins SR. What Is the Status of Women\u2019s Health and Health Care in the U.S. Compared to Ten Other Countries? Commonwealth Fund. 2018. DOI: 10.26099\/wy8a\u20107w13."},{"key":"e_1_3_1_65_2","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0000000000000746"},{"key":"e_1_3_1_66_2","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0000000000001981"},{"key":"e_1_3_1_67_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCOUTCOMES.118.005417"},{"key":"e_1_3_1_68_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIR.0000000000000772"},{"key":"e_1_3_1_69_2","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehy340"},{"key":"e_1_3_1_70_2","doi-asserted-by":"publisher","DOI":"10.1007\/s11936-019-0789-1"},{"key":"e_1_3_1_71_2","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehr218"},{"key":"e_1_3_1_72_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2008.05.013"},{"key":"e_1_3_1_73_2","doi-asserted-by":"publisher","DOI":"10.1002\/ejhf.586"},{"key":"e_1_3_1_74_2","doi-asserted-by":"publisher","DOI":"10.1002\/ejhf.2133"},{"key":"e_1_3_1_75_2","doi-asserted-by":"publisher","DOI":"10.1136\/heartjnl-2015-308285"},{"key":"e_1_3_1_76_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2018.10.075"},{"key":"e_1_3_1_77_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.thromres.2018.07.022"},{"key":"e_1_3_1_78_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ahj.2015.05.003"},{"key":"e_1_3_1_79_2","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0000000000003018"},{"key":"e_1_3_1_80_2","doi-asserted-by":"publisher","DOI":"10.1002\/ejhf.188"},{"key":"e_1_3_1_81_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijoa.2020.06.001"},{"key":"e_1_3_1_82_2","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehx355"},{"key":"e_1_3_1_83_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2019.11.014"},{"key":"e_1_3_1_84_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.healun.2011.11.018"},{"key":"e_1_3_1_85_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.healun.2010.05.034"},{"key":"e_1_3_1_86_2","first-page":"72063","article-title":"Content and format of labeling for human prescription drug and biological products; requirements for pregnancy and lactation labeling. Final rule","volume":"79","author":"Food, Drug Administration HHS","year":"2014","unstructured":"Food, Drug Administration HHS . Content and format of labeling for human prescription drug and biological products; requirements for pregnancy and lactation labeling. Final rule. Fed Regist. 2014;79:72063\u201372103.","journal-title":"Fed Regist"},{"key":"e_1_3_1_87_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacbts.2019.01.010"},{"key":"e_1_3_1_88_2","doi-asserted-by":"publisher","DOI":"10.1002\/clc.23249"},{"key":"e_1_3_1_89_2","doi-asserted-by":"publisher","DOI":"10.1213\/ANE.0000000000005266"},{"key":"e_1_3_1_90_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.athoracsur.2016.03.005"},{"key":"e_1_3_1_91_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2013.05.019"},{"key":"e_1_3_1_92_2","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-143-10-200511150-00006"},{"key":"e_1_3_1_93_2","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0000000000003728"},{"key":"e_1_3_1_94_2","unstructured":"Martin JA Hamilton BE Osterman MJK. Births in the United States 2017. NCHS Data Brief No 318. 2018:1\u20138."},{"key":"e_1_3_1_95_2","doi-asserted-by":"publisher","DOI":"10.1007\/s11897-018-0392-x"},{"key":"e_1_3_1_96_2","first-page":"36","article-title":"Contraception and reproductive counseling in women with peripartum cardiomyopathy","volume":"96","author":"Rosman L","year":"2017","unstructured":"Rosman L, Salmoirago\u2010Blotcher E, Wuensch KL, Cahill J, Sears SF. Contraception and reproductive counseling in women with peripartum cardiomyopathy. Contraception. 2017;96:36\u201340. DOI: 10.1016\/j.contraception.2017.05.003.","journal-title":"Contraception"},{"key":"e_1_3_1_97_2","doi-asserted-by":"publisher","DOI":"10.1097\/MD.0000000000019524"},{"key":"e_1_3_1_98_2","doi-asserted-by":"publisher","DOI":"10.1007\/s11936-019-0745-0"},{"key":"e_1_3_1_99_2","doi-asserted-by":"publisher","DOI":"10.1097\/GRF.0000000000000361"}],"container-title":["Journal of the American Heart Association"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ahajournals.org\/doi\/full\/10.1161\/JAHA.121.021019","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,5,13]],"date-time":"2024-05-13T07:24:33Z","timestamp":1715585073000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ahajournals.org\/doi\/10.1161\/JAHA.121.021019"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,7,20]]},"references-count":98,"journal-issue":{"issue":"14","published-print":{"date-parts":[[2021,7,20]]}},"alternative-id":["10.1161\/JAHA.121.021019"],"URL":"https:\/\/doi.org\/10.1161\/jaha.121.021019","relation":{},"ISSN":["2047-9980"],"issn-type":[{"value":"2047-9980","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,7,20]]},"assertion":[{"value":"2021-01-24","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2021-04-26","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2021-07-14","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e021019"}}