{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T01:55:12Z","timestamp":1787018112432,"version":"build-2736575974"},"reference-count":58,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"5","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2026,3,3]]},"abstract":"<jats:sec xml:lang=\"en\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p xml:lang=\"en\">Pregnancy\u2010related complications are linked to increased cardiovascular disease risk, but comprehensive evaluations of diverse complications, particularly multiple or recurrent events, are limited.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p xml:lang=\"en\">A national retrospective cohort study was conducted using the Secure Anonymised Information Linkage (SAIL) Databank in Wales. Exposures were hypertensive disorders of pregnancy, gestational diabetes, placental abruption, stillbirth, small for gestational age, fetal growth restriction, and preterm birth. Multiple complications were defined as &gt;1 complication in the first pregnancy, and recurrent complications as the same complication in both the first and second pregnancies. Outcomes were incident ischemic heart disease, stroke, heart failure, and atrial fibrillation. Cox regression estimated hazard ratios (HRs).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p xml:lang=\"en\">A total of 298\u2009515 women (mean age 27.2\u2009years; SD 6.1) were included. Multiple pregnancy\u2010related complications were associated with increased risk of ischemic heart disease (hazard ratio HR, 2.88 [95% CI, 2.27\u20133.67]), stroke (HR, 2.03 [95% CI, 1.55\u20132.65]), heart failure (HR, 3.18 [95% CI, 2.34\u20134.32]), and atrial fibrillation (HR, 1.80 [95% CI, 1.20\u20132.72]) compared with no complications. A dose\u2013response relationship was observed, with progressively higher cardiovascular disease risk for multiple compared with single complications and elevated risk for both groups relative to women without complications. Recurrent pregnancy\u2010related complications increased the risk of ischemic heart disease (HR, 1.93 [95% CI, 1.26\u20132.95]), stroke (HR, 1.89 [95% CI, 1.25\u20132.85]), heart failure (HR, 3.61 [95% CI, 2.32\u20135.60]), and atrial fibrillation (HR, 2.45 [95% CI, 1.38\u20134.37]) compared with no complication.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p xml:lang=\"en\">Women experiencing pregnancy\u2010related complications encounter higher risks of cardiovascular disease, especially with multiple or recurrent complications. Comprehensive cardiovascular risks assessment and targeted prevention should be prioritized for this group.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1161\/jaha.125.044953","type":"journal-article","created":{"date-parts":[[2026,2,20]],"date-time":"2026-02-20T12:20:35Z","timestamp":1771590035000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":2,"title":["Single\u2010Multiple and Recurrent Pregnancy\u2010Related Complications and Incident Cardiovascular Disease: A Nationwide Data Linkage Study in Wales, UK"],"prefix":"10.1161","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3803-9691","authenticated-orcid":false,"given":"Tariq","family":"Al Bahhawi","sequence":"first","affiliation":[{"name":"Liverpool John Moores University & Liverpool Heart and Chest Hospital","place":["Liverpool, UK"]},{"name":"University of Liverpool","place":["UK"]},{"name":"Jazan University","place":["Jazan, Saudi Arabia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephanie L.","family":"Harrison","sequence":"additional","affiliation":[{"name":"Liverpool John Moores University & Liverpool Heart and Chest Hospital","place":["Liverpool, UK"]},{"name":"University of Liverpool","place":["UK"]},{"name":"Flinders University","place":["Bedford Park, Australia"]},{"name":"South Australian Health and Medical Research Institute (SAHMRI)","place":["Adelaide, Australia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5604-9378","authenticated-orcid":false,"given":"Deirdre A.","family":"Lane","sequence":"additional","affiliation":[{"name":"Liverpool John Moores University & Liverpool Heart and Chest Hospital","place":["Liverpool, UK"]},{"name":"University of Liverpool","place":["UK"]},{"name":"Aalborg University","place":["Aalborg, Denmark"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2975-647X","authenticated-orcid":false,"given":"Flemming","family":"Skj\u00f8th","sequence":"additional","affiliation":[{"name":"Aalborg University","place":["Aalborg, Denmark"]},{"name":"University Hospitals of Southern Denmark","place":["Vejle, Denmark"]},{"name":"University of Southern Denmark","place":["Odense, Denmark"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3392-1650","authenticated-orcid":false,"given":"Iain","family":"Buchan","sequence":"additional","affiliation":[{"name":"University of Liverpool","place":["Liverpool, UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3396-7464","authenticated-orcid":false,"given":"Andrew","family":"Sharp","sequence":"additional","affiliation":[{"name":"University of Liverpool","place":["UK"]},{"name":"Liverpool Women\u2019s Hospital NHS Foundation Trust","place":["Liverpool, UK"]},{"name":"University of Liverpool","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9575-4758","authenticated-orcid":false,"given":"Hoda","family":"Abbasizanjani","sequence":"additional","affiliation":[{"name":"Swansea University","place":["Swansea, UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0814-0801","authenticated-orcid":false,"given":"Ashley","family":"Akbari","sequence":"additional","affiliation":[{"name":"Swansea University","place":["Swansea, UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5853-4625","authenticated-orcid":false,"given":"Fatemeh","family":"Torabi","sequence":"additional","affiliation":[{"name":"Swansea University","place":["Swansea, UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6926-2947","authenticated-orcid":false,"given":"Julian","family":"Halcox","sequence":"additional","affiliation":[{"name":"Swansea University","place":["Swansea, UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0270-0150","authenticated-orcid":false,"given":"Dharani K.","family":"Hapangama","sequence":"additional","affiliation":[{"name":"Liverpool Women\u2019s Hospital NHS Foundation Trust","place":["Liverpool, UK"]},{"name":"University of Liverpool","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7566-1626","authenticated-orcid":false,"given":"Gregory Y. 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