CaNCaM-Preg
The Canadian Network of Networks to Reduce Cardiovascular Morbidity and Mortality in Pregnancy
Improving Cardiovascular Health During and After Pregnancy
CaNCaM-Preg is a national, interdisciplinary initiative focused on reducing preventable cardiovascular morbidity and mortality associated with pregnancy. It is one of two initiatives awarded the Research Networks of Excellence in Heart and Brain Health grant and has received $5 million in funding over five years from Heart & Stroke, Brain Canada, and the Canadian Institutes of Health Research – Institute of Gender and Health.
Through collaboration across institutions, disciplines, and provinces, and grounded in the principles of Equity, Diversity, and Inclusion (EDI), CaNCaM-Preg seeks to understand the cardiovascular risks associated with pregnancy and address systemic disparities in outcomes that disproportionately affect minoritized, immigrant, and Indigenous populations.
Why Cardiovascular Health in Pregnancy Matters
Pregnancy causes significant changes in the cardiovascular system. These changes can lead to serious complications – including severe illness, long-term disability, or death - in individuals with pre-existing heart disease, as well as those without known cardiac conditions who cannot physiologically adapt.
Cardiovascular conditions are the leading cause of non-obstetric maternal mortality and morbidity worldwide, and at least 50% of these events are preventable. Despite this, key risk factors remain unexplored, particularly those affecting underrepresented populations in Canada.
CaNCaM-Preg addresses these gaps through three interconnected program areas:
Program Area 1
CanOSS-CV: National Confidential Enquiry into Cardiovascular Morbidity in Pregnancy
CanOSS-CV is a multicentre, prospective confidential enquiry study that will establish a structured Canadian process for reviewing severe pregnancy-associated cardiovascular morbidity. Using the CanOSS framework, it will identify clinical, structural, and health-system factors contributing to severe cardiovascular events and opportunities to improve care.
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Engages cardio-obstetrics centres across Canada through the CanCOB network
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Examines severe cardiovascular events occurring from conception to one year postpartum
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Combines standardized clinical data with narrative information to understand how and why events occur
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Uses confidential, multidisciplinary case review to identify contributing factors
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Explores disparities across populations, regions, and care settings
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Develops actionable, equity-informed recommendations for clinicians, institutions, health systems, and policymakers
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Engages persons with lived experience in study processes and knowledge mobilization
Program Area 2
CCOC – Canadian Cardio-Obstetrics Collaboration
This program will establish a cardio-obstetrics research and care network across Canada, starting with nine units. A prospective multicentre cohort study will compare cardiovascular recovery after pregnancy in individuals with and without heart disease.
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Measures long-term cardiac remodelling
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Compares cardiovascular risk profiles post-pregnancy
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Examines associations between postpartum cardiovascular events and risk development
Program Area 3
CanVaHD – Canadian Network for Valvular Heart Disease in Pregnancy
This area will build a national network to study and improve care for individuals with rheumatic valvular heart disease, a condition that disproportionately affects minoritized, immigrant, and Indigenous communities.
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Conducts a pan-Canadian validation of a population-specific risk stratification tool
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Analyzes maternal and fetal outcomes from diverse anticoagulation management strategies
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Evaluates trade-offs between maternal and neonatal health in high-risk pregnancies
Leadership, Collaboration, and Feasibility
CaNCaM-Preg is led by experts in cardio-obstetrics, health equity, and patient-centered research. The team includes national and provincial leads, content theme experts, and individuals with lived experience. The initiative builds on CIHR-funded feasibility work and an existing Knowledge Mobilization Hub that supports education, implementation, and community engagement.
By uniting interdisciplinary knowledge with real-world data, CaNCaM-Preg aims to reduce pregnancy-related cardiovascular events and serve as a national platform for ongoing research, care improvement, and health equity.