A 20-year population study of peripartum cardiomyopathy

Alice M. Jackson, Mark Macartney, Katriona Brooksbank, Carolyn Brown, Dana Dawson, Mark Francis, Alan Japp, Vera Lennie, Stephen J Leslie, Thomas Martin, Paul Neary, Sowmya Venkatasubramanian, Debra Vickers, Robin A. Weir, John J. V. McMurray, Pardeep S. Jhund (Lead / Corresponding author), Mark C. Petrie (Lead / Corresponding author)

Research output: Contribution to journalArticlepeer-review

6 Citations (Scopus)
44 Downloads (Pure)

Abstract

Background and Aims: The epidemiology of peripartum cardiomyopathy (PPCM) in Europe is poorly understood and data on long-term outcomes are lacking. A retrospective, observational, population-level study of validated cases of PPCM in Scotland from 1998 to 2017 was conducted.

Methods: Women hospitalized with presumed de novo left ventricular systolic dysfunction around the time of pregnancy and no clear alternative cause were included. Each case was matched to 10 controls. Incidence and risk factors were identified. Morbidity and mortality were examined in mothers and children.

Results: The incidence of PPCM was 1 in 4950 deliveries. Among 225 women with PPCM, obesity, gestational hypertensive disorders, and multi-gestation were found to be associated with having the condition. Over a median of 8.3 years (9.7 years for echocardiographic outcomes), 8% of women with PPCM died and 75% were rehospitalized for any cause at least once. Mortality and rehospitalization rates in women with PPCM were ∼12- and ∼3-times that of controls, respectively. The composite of all-cause death, mechanical circulatory support, or cardiac transplantation occurred in 14%. LV recovery occurred in 76% and, of those who recovered, 13% went on to have a decline in LV systolic function despite initial recovery. The mortality rate for children born to women with PPCM was ∼5-times that of children born to controls and they had an ∼3-times greater incidence of cardiovascular disease over a median of 8.8 years.

Conclusions: PPCM affected 1 in 4950 women around the time of pregnancy. The condition is associated with considerable morbidity and mortality for the mother and child. There should be a low threshold for investigating at-risk women. Long term follow-up, despite apparent recovery, should be considered.
Original languageEnglish
Pages (from-to)5128-5141
Number of pages14
JournalEuropean Heart Journal
Volume44
Issue number48
Early online date7 Oct 2023
DOIs
Publication statusPublished - 21 Dec 2023

Keywords

  • Peripartum cardiomyopathy
  • Incidence
  • Outcomes
  • Recovery

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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