Jackson, A. M. et al. (2023) A 20-year population study of peripartum cardiomyopathy. European Heart Journal, (doi: 10.1093/eurheartj/ehad626) (PMID:37804234) (Early Online Publication)
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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.
| Item Type: | Articles |
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| Additional Information: | The study was funded by the British Heart Foundation (BHF) through a BHF Clinical Research Training Fellowship (FS/18/14/33330) awarded to AMJ. JJV, PSJ and MCP are funded by the BHF Centre of Research Excellence Grant RE/18/6/34217 and the Vera Melrose Heart Failure Research Fund. |
| Status: | Early Online Publication |
| Refereed: | Yes |
| Glasgow Author(s) Enlighten ID: | Brooksbank, Dr Katriona and Jackson, Dr Alice and Jhund, Professor Pardeep and Petrie, Professor Mark and McMurray, Professor John |
| Authors: | Jackson, A. M., Macartney, M., Brooksbank, K., Brown, C., Dawson, D., Francis, M., Japp, A., Lennie, V., Leslie, S. J., Martin, T., Neary, P., Venakatasubramanian, S., Vickers, D., Weir, R. A., McMurray, J. J.V., Jhund, P. S., and Petrie, M. C. |
| College/School: | College of Medical Veterinary and Life Sciences > School of Cardiovascular & Metabolic Health |
| Journal Name: | European Heart Journal |
| Publisher: | Oxford University Press |
| ISSN: | 0195-668X |
| ISSN (Online): | 1522-9645 |
| Published Online: | 07 October 2023 |
| Copyright Holders: | Copyright © 2023 The Authors |
| First Published: | First published in European Heart Journal 2023 |
| Publisher Policy: | Reproduced under a Creative Commons License |
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