# Cardiovascular Disease in Pregnancy and the Postpartum Period in Maryland

> **NIH NIH R03** · JOHNS HOPKINS UNIVERSITY · 2021 · $81,875

## Abstract

Cardiovascular disease (CVD) is the leading cause of pregnancy-related mortality and an important
contributor to severe maternal morbidity (SMM) in the United States. Both pregnancy-related mortality
and SMM have been increasing over the past two decades. This study will examine hospital encounters
with a CVD diagnosis in all women of reproductive age (15-49 years), with a subsequent focus on
pregnant and postpartum women. More specifically, we will explore relationships between pre-
pregnancy CVD, SMM and CVD beyond the postpartum period. We will use data from a family of
Maryland state databases that comprise the universe of hospital discharges and emergency
Department (ED) visits in the state during 2013-2019. Our primary analytic sample will be comprised of
all women of reproductive age with at least one hospital encounter (inpatient or ED visit) in Maryland
hospitals during this period; data from only women with one or more delivery hospitalizations during the
same period will comprise a secondary analytic sample. We will derive two outcome measures, a
primary and an associated CVD encounter measure, as well as SMM and CVD-SMM measures using
Centers for Disease Control and Prevention’s ICD-based algorithm. Following exploratory analyses, we
will use statistical methods developed specifically for use with longitudinal data to address our specific
aims. Of note, survival analysis techniques will be employed to examine time to hospital encounters
with CVD diagnosis for the various subpopulations of interest at different times of CVD risk during the
period of investigation; and, random effects models adjusted for key (time-varying) patient and hospital
characteristics will be fitted to examine whether a previous CVD hospital encounter or a significant
pattern of CVD hospital encounter predicts SMM/CVD-SMM during delivery vs. postpartum
hospitalizations, and whether SMM/CVD-SMM predicts a subsequent CVD hospital encounter. To our
knowledge, this will be the first population-based study to examine hospital encounters with a CVD
diagnosis in all women of reproductive age and also the first to explore relationships between pre-
pregnancy CVD, SMM and CVD beyond the postpartum period using a longitudinal approach. Our
results will be disseminated in the peer-reviewed literature and through presentations at scientific
meetings. This pilot study will provide preliminary data for larger grant applications aiming to design
interventions to prevent CVD in women over their life course.

## Key facts

- **NIH application ID:** 10195079
- **Project number:** 1R03HD104888-01
- **Recipient organization:** JOHNS HOPKINS UNIVERSITY
- **Principal Investigator:** Andreea Alina Creanga
- **Activity code:** R03 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2021
- **Award amount:** $81,875
- **Award type:** 1
- **Project period:** 2021-04-01 → 2023-03-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10195079

## Citation

> US National Institutes of Health, RePORTER application 10195079, Cardiovascular Disease in Pregnancy and the Postpartum Period in Maryland (1R03HD104888-01). Retrieved via AI Analytics 2026-05-22 from https://api.ai-analytics.org/grant/nih/10195079. Licensed CC0.

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