{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,4]],"date-time":"2026-09-04T03:32:58Z","timestamp":1788492778190,"version":"build-2803163510"},"reference-count":37,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"10","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2023,5,16]]},"abstract":"<jats:sec sec-type=\"background\" xml:lang=\"en\">\n            <jats:title>Background<\/jats:title>\n            <jats:p xml:lang=\"en\">Guidelines for choice of prosthetic heart valve in people of reproductive age are not well established. Although biologic heart valves (BHVs) have risk of deterioration, mechanical heart valves (MHVs) require lifelong anticoagulation. This study aimed to characterize the association of prosthetic valve type with maternal and fetal outcomes in pregnant patients.<\/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\">Using the 2008 to 2019 National Inpatient Sample, we identified all adult patients hospitalized for delivery with prior heart valve implantation. Multivariable regressions were used to analyze the primary outcome, major adverse cardiovascular events, and secondary outcomes, including maternal and fetal complications, length of stay, and costs. Among 39\u2009871\u2009862 birth hospitalizations, 4152 had MHVs and 874 had BHVs. Age, comorbidities, and cesarean birth rates were similar between patients with MHVs and BHVs. The presence of a prosthetic valve was associated with over 22\u2010fold increase in likelihood of major adverse cardiovascular events (MHV: adjusted odds ratio, 22.1 [95% CI, 17.3\u201328.2]; BHV: adjusted odds ratio, 22.5 [95% CI, 13.9\u201336.5]) as well as increased duration of stay and hospitalization costs. However, patients with MHVs and BHVs had no significant difference in the odds of any maternal outcome, including major adverse cardiovascular events, hypertensive disease of pregnancy, and ante\/postpartum hemorrhage. Similarly, fetal complications were more likely in patients with valve prostheses, including a 4\u2010fold increase in odds of stillbirth, but remained comparable between MHVs and BHVs.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p xml:lang=\"en\">Patients hospitalized for delivery with prior valve replacement carry substantial risk of adverse maternal and fetal events, regardless of valve type. Our findings reveal comparable outcomes between MHVs and BHVs.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/jaha.122.028653","type":"journal-article","created":{"date-parts":[[2023,5,15]],"date-time":"2023-05-15T10:12:43Z","timestamp":1684145563000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":17,"title":["Maternal and Fetal Outcomes in Pregnant Patients With Mechanical and Bioprosthetic Heart Valves"],"prefix":"10.1161","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8283-4436","authenticated-orcid":false,"given":"Ayesha P.","family":"Ng","sequence":"first","affiliation":[{"name":"Cardiovascular Outcomes Research Laboratories (CORELAB), Division of Cardiac Surgery David Geffen School of Medicine at UCLA Los Angeles CA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arjun","family":"Verma","sequence":"additional","affiliation":[{"name":"Cardiovascular Outcomes Research Laboratories (CORELAB), Division of Cardiac Surgery David Geffen School of Medicine at UCLA Los Angeles CA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yas","family":"Sanaiha","sequence":"additional","affiliation":[{"name":"Cardiovascular Outcomes Research Laboratories (CORELAB), Division of Cardiac Surgery David Geffen School of Medicine at UCLA Los Angeles CA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3485-8801","authenticated-orcid":false,"given":"Catherine G.","family":"Williamson","sequence":"additional","affiliation":[{"name":"Cardiovascular Outcomes Research Laboratories (CORELAB), Division of Cardiac Surgery David Geffen School of Medicine at UCLA Los Angeles CA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3807-7022","authenticated-orcid":false,"given":"Yalda","family":"Afshar","sequence":"additional","affiliation":[{"name":"Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology David Geffen School of Medicine at UCLA Los Angeles CA USA"},{"name":"Molecular Biology Insitute University of California Los Angeles CA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4705-0262","authenticated-orcid":false,"given":"Peyman","family":"Benharash","sequence":"additional","affiliation":[{"name":"Cardiovascular Outcomes Research Laboratories (CORELAB), Division of Cardiac Surgery David Geffen School of Medicine at UCLA Los Angeles CA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_1_2_2","doi-asserted-by":"publisher","DOI":"10.1161\/hc3001.093437"},{"key":"e_1_3_1_3_2","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehq200"},{"key":"e_1_3_1_4_2","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehs270"},{"key":"e_1_3_1_5_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIR.0000000000000458"},{"key":"e_1_3_1_6_2","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0000000000003243"},{"key":"e_1_3_1_7_2","doi-asserted-by":"publisher","DOI":"10.3978\/j.issn.2225-319X.2015.07.01"},{"key":"e_1_3_1_8_2","first-page":"399","article-title":"Tissue and mechanical heart valves","volume":"4","author":"Harris C","year":"2015","unstructured":"Harris C, Croce B, Cao C. 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