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Development of Longitudinal, Linked Maternal-Infant Cohorts using the Epic Cosmos Electronic Health Record Dataset
Medrxiv : the Preprint Server for Health Sciences
|June 12, 2026
Summary
This study demonstrates a reproducible method for creating longitudinal maternal-infant cohorts using Epic Cosmos data. High blood pressure in early pregnancy increases preeclampsia risk in women with chronic hypertension.
Area of Science:
- Perinatal epidemiology
- Electronic health records research
- Reproductive health data analytics
Background:
- Epic Cosmos is a centralized electronic health record dataset with significant potential for perinatal research.
- Developing robust methods for utilizing this data is crucial for advancing our understanding of maternal and infant health outcomes.
Purpose of the Study:
- To establish reproducible steps for creating longitudinal, linked maternal-infant cohorts within Epic Cosmos.
- To assess the completeness of key variables and evaluate potential selection bias.
- To conduct an example epidemiologic analysis using the developed cohorts.
Main Methods:
- Maternal-infant cohorts were constructed from live births (2023-2024) linked with additional data tables.
- Variables for perinatal characteristics, comorbidities, and lab values were selected and assessed for completeness.
- Cohorts were restricted for longitudinal data from first-trimester prenatal care through infant follow-up, and an analysis of hypertension and preeclampsia was performed.
Main Results:
- The total linked birth cohort comprised 2,624,186 pregnancies, with high data completeness (>90%) for most variables.
- Longitudinal cohort restrictions reduced the cohort size but minimally impacted characteristics, indicating representativeness.
- Elevated first-trimester systolic blood pressure was associated with a 26% increased risk of preeclampsia in women with chronic hypertension.
Conclusions:
- A rigorous and reproducible approach for creating longitudinal maternal-infant cohorts in Epic Cosmos was successfully developed.
- The study findings indicate high data quality and representativeness within the Epic Cosmos dataset for perinatal research.
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