Outcomes
Adverse events during the ante-, peri-, and postpartum periods were
classified as maternal cardiac, obstetrical, and fetal/neonatal. Two
physicians (JG, AC) blinded to the women’s baseline characteristics
independently verified adverse events. Adverse cardiac events were
defined as any of the following: left sided heart failure (HF) defined
as pulmonary edema documented by chest radiograph or crackles heard over
at least one third of posterior lung fields and jugular venous
distension, right-sided HF, sustained atrial or ventricular
tachyarrhythmias requiring treatment, stroke or transient ischemic
attack, cardiac thromboembolism, myocardial infarction, cardiac arrest,
or cardiac death. Obstetrical outcomes were defined as gestational
hypertension, pre-eclampsia or eclampsia, hemorrhage, and premature
rupture of membranes. Fetal and neonatal complications were defined as
miscarriages, premature birth (<37 weeks gestation),
small-for-gestational-age birth weight (<10th percentile for
gestational age and sex or < 2500 g), neonatal ICU admission,
fetal death (after 20 weeks gestation and before birth), or neonatal
death (from birth to age 28 days).