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Women with Caesarean section delivery have a higher risk of subsequent coronary heart disease than women with vaginal deliveryHui-Bih Yuan; Chun-Jen HuangBackground: This population-based cohort study was conducted to elucidate the impact of Caesarean section (CS) delivery on the future risk of coronary heart disease (CHD) in pregnant women.Methods: We analyzed data retrieved from the Longitudinal Health Insurance Database 2010, which includes medical claims data and registration files for 1 million enrollees randomly selected from the 2010 Registry for Beneficiaries (n = 23.7 million) of the National Health Insurance program in Taiwan. Subjects with a newly diagnosed CHD after delivery were identified with ICD-9-CM codes between January, 2000 and December, 2012. At least two separate inpatient or outpatient medical record diagnosis of CHD were included in this study to confirm the accuracy of the diagnosis. Multivariate Cox proportional-hazards regression models were performed to estimate the hazard ratios (HRs) and the 95% confidence intervals (CIs). Results: A total of 52322 pregnant women were included (CS delivery: n=18153; vaginal delivery: n=34169). During 1 to 13 years of follow-up, the incidence of having subsequent CHD in women with CS delivery was significantly higher than that in women with vaginal delivery (1.4% vs. 0.9%; P