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Physiologic changes accompanying pregnancy, including increased blood volume and elevated heart rate, are well tolerated by healthy women but may be deleterious for women with chronic heart disease and their babies. Using Washington State hospital data, investigators explored associations between maternal chronic heart disease (defined as congenital heart disease, heart failure, ischemic heart disease, or pulmonary hypertension) and pregnancy outcomes. From 1987 through 2009, 2171 births were to women with chronic heart disease. The proportion of births to mothers with chronic heart disease rose more than threefold from the first third to the last third of this period (from 56 to 179 per 100,000 births).
The incidence of small-for-gestationa…