Figure 1. Cohort construction.

*Values are rounded either up or down to a multiple of ‘5’ (for patient confidentiality purposes). †Preexisting diabetes or hypertension in the mother, defined as ≥1 inpatient and/or ≥2 outpatient ICD codes for any form of diabetes or hypertension in the 2 y before 20 weeks' gestational age of the first pregnancy. ‡Stillbirths were identified from the stillbirth registry. In the case of a stillbirth, it is not possible to identify the father since there is an absence of paternal information in the stillbirth registry (registry is linked only to mothers). §Fatal events occurring at any point between 20 wks' gestation of the second pregnancy and 12 weeks' postpartum. Five deaths were related to a fatal CVD event while the remaining 15 fatalities were related to obstetrical complications related to childbirth, major trauma and suicide. ||The CVD‐related exclusion criteria included codes for myocardial infarction, stroke, angina, and other circulatory system disease conditions (atrial fibrillation, heart failure, other ischemic disease, other cardiac dysrhythmias, peripheral vascular disease, and venous thromboembolism). We required ≥1 inpatient diagnosis, 1 related surgical procedure (angioplasty, endarterectomy, or coronary artery bypass surgery), or ≥2 outpatient diagnoses, occurring 2 y before 12 wks' postpartum of the second pregnancy (index date), to define prior CVD events. #Defined as ≥1 inpatient and/or ≥2 outpatient (within 2 years) diabetes‐related or hypertension‐related ICD codes occurring between 12 wks' postpartum of the first pregnancy and 20 wks' gestation of the second pregnancy. CVD indicates cardiovascular disease; ICD, International Classification of Diseases; and GHTN, gestational hypertension.