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Epidemiology of Cardiovascular Disease in Pregnancy in Japan　- Analysis of a Nationwide Perinatal Database 2014-2023

Masafumi Nii1, Shoko Chishaki-Kawabata2, Koshiro Kanaoka2

  • 1Department of Obstetrics and Gynecology, Mie University Graduate School of Medicine.

Circulation Journal : Official Journal of the Japanese Circulation Society
|June 7, 2026
PubMed

Insights

Approximately 1.23% of pregnancies in Japan involve cardiovascular disease (CVD). Women with CVD experienced more interventions and a slightly increased risk of maternal complications and death, highlighting the need for careful monitoring.

Area of Science:

  • Obstetrics and Gynecology
  • Cardiology
  • Public Health

Background:

  • Cardiovascular disease (CVD) is a growing cause of maternal health issues globally.
  • Limited contemporary data exists on CVD complications in Japanese pregnancies.

Purpose of the Study:

  • To analyze nationwide data on maternal cardiovascular disease in Japan.
  • To assess the impact of CVD on pregnancy outcomes and interventions.

Main Methods:

  • Retrospective cohort study using the Japan Society of Obstetrics and Gynecology Perinatal Database (2014-2023).
  • Compared 26,894 pregnancies with CVD against a low-risk population (n=1,882,896).

Main Results:

  • 1.23% of pregnancies were complicated by maternal CVD.
  • CVD pregnancies had lower parity, more cesarean deliveries, general anesthesia, and labor analgesia.
  • Higher rates of hypertensive disorders, pulmonary embolism, and pulmonary edema were observed in pregnancies with CVD.
  • Maternal death was rare but more frequent in pregnancies with CVD (0.03% vs 0.01%).
  • Neonatal outcomes were similar between groups.

Conclusions:

  • Maternal CVD affects approximately 1% of pregnancies in Japan.
  • Women with CVD require more obstetric and anesthetic interventions.
  • There is a modestly increased risk of maternal morbidity and mortality in pregnancies with CVD.
  • Findings support continued registry surveillance for risk-stratified perinatal care.
Abstract

Keywords:
Cardiovascular diseaseEpidemiologyPerinatal outcomesPregnancyRegistry

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