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).