{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,10]],"date-time":"2026-10-10T00:15:40Z","timestamp":1791591340469,"version":"4.3.4"},"reference-count":30,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"9","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2023,5,2]]},"abstract":"<jats:sec sec-type=\"background\" xml:lang=\"en\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p xml:lang=\"en\">Aortic dissection (AD) during pregnancy and puerperium is a rare catastrophe with devastating consequences for both parent and fetus. Population\u2010level incidence trends and outcomes remain relatively undetermined.<\/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 queried a US population\u2010based health care database, the National Inpatient Sample, and identified all patients with a pregnancy\u2010related AD hospitalization\u00a0from 2002 to 2017. In total, 472 pregnancy\u2010related AD hospitalizations (mean age, 30.9\u00b10.6\u2009years) were identified from 68\u2009514\u2009000 pregnancy\u2010related hospitalizations (0.69 per 100\u2009000 pregnancy\u2010related hospitalizations), with 107 (22.7%) being type A and 365 (77.3%) being type B. The incidence of AD appeared to increase over the 16\u2010year study period but was not statistically significant (\n                      <jats:italic>P<\/jats:italic>\n                      for trend &gt;0.05). Marfan syndrome, primary hypertension, and preeclampsia\/eclampsia were found in 21.9%, 14.4%, and 11.5%, respectively. On multivariable logistic regression analysis, Marfan syndrome was associated with the highest risk of developing AD during pregnancy and puerperium (adjusted odds ratio, 3469.36 [95% CI, 1767.84\u20136831.75];\n                      <jats:italic>P<\/jats:italic>\n                      &lt;0.001). The in\u2010hospital mortalities of AD, type A AD, and type B AD were 7.3%, 4.3%, and 8.1%, respectively. Length of hospital stay for the AD, type A AD, and type B AD groups were 7.7\u00b10.8, 10.4\u00b11.9, and 6.9\u00b10.9\u2009days, respectively.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p xml:lang=\"en\">We quantified population\u2010level incidence and in\u2010hospital mortality in the United States and observed an increase in the incidence of pregnancy\u2010related AD. In contrast, its in\u2010hospital mortality appears lower than that of non\u2013pregnancy\u2010related AD.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1161\/jaha.122.028436","type":"journal-article","created":{"date-parts":[[2023,4,29]],"date-time":"2023-04-29T06:53:28Z","timestamp":1682751208000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":28,"title":["Aortic Dissection During Pregnancy and Puerperium: Contemporary Incidence and Outcomes in the United States"],"prefix":"10.1161","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0018-8109","authenticated-orcid":false,"given":"Yunda","family":"Wang","sequence":"first","affiliation":[{"name":"Division of Cardiac Surgery, Boston Medical Center Boston University Chobanian &amp; Avedisian School of Medicine MA Boston"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4769-3129","authenticated-orcid":false,"given":"Kanhua","family":"Yin","sequence":"additional","affiliation":[{"name":"Department of Surgery Washington University School of Medicine St. Louis MO"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1457-3048","authenticated-orcid":false,"given":"Yesh","family":"Datar","sequence":"additional","affiliation":[{"name":"Division of Cardiac Surgery, Boston Medical Center Boston University Chobanian &amp; Avedisian School of Medicine MA Boston"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3797-221X","authenticated-orcid":false,"given":"Joy","family":"Mohnot","sequence":"additional","affiliation":[{"name":"Division of Cardiac Surgery, Boston Medical Center Boston University Chobanian &amp; Avedisian School of Medicine MA Boston"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1474-4871","authenticated-orcid":false,"given":"Ariana Y.","family":"Nodoushani","sequence":"additional","affiliation":[{"name":"Division of Cardiac Surgery, Boston Medical Center Boston University Chobanian &amp; Avedisian School of Medicine MA Boston"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4144-9915","authenticated-orcid":false,"given":"Yong","family":"Zhan","sequence":"additional","affiliation":[{"name":"CardioVascular Center Tufts Medical Center MA Boston"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1943-4493","authenticated-orcid":false,"given":"Karl J.","family":"Karlson","sequence":"additional","affiliation":[{"name":"Division of Cardiac Surgery, Boston Medical Center Boston University Chobanian &amp; Avedisian School of Medicine MA Boston"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8345-5323","authenticated-orcid":false,"given":"Niloo M.","family":"Edwards","sequence":"additional","affiliation":[{"name":"Division of Cardiac Surgery, Boston Medical Center Boston University Chobanian &amp; Avedisian School of Medicine MA Boston"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2880-6132","authenticated-orcid":false,"given":"Michael J.","family":"Reardon","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Surgery Houston Methodist Hospital Houston TX"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nikola","family":"Dobrilovic","sequence":"additional","affiliation":[{"name":"Division of Cardiac Surgery NorthShore University HealthSystem Chicago IL"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamacardio.2020.4876"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2014.12.066"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.116.021594"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehaa497"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1136\/heartjnl-2020-318183"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehz136"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-143-10-200511150-00006"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.105.576751"},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199609123351102"},{"key":"e_1_3_2_11_2","doi-asserted-by":"publisher","DOI":"10.1093\/ejcts\/ezaa048"},{"key":"e_1_3_2_12_2","doi-asserted-by":"publisher","DOI":"10.1161\/JAHA.116.004052"},{"key":"e_1_3_2_13_2","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehi103"},{"key":"e_1_3_2_14_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2021.06.034"},{"key":"e_1_3_2_15_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2012.03.051"},{"key":"e_1_3_2_16_2","doi-asserted-by":"publisher","DOI":"10.1111\/aogs.14104"},{"key":"e_1_3_2_17_2","doi-asserted-by":"publisher","DOI":"10.1007\/s12471-019-01340-w"},{"key":"e_1_3_2_18_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.athoracsur.2016.08.089"},{"key":"e_1_3_2_19_2","unstructured":"Introduction to the HCUP National Inpatient Sample (NIS) . 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