Does peripartum cardiomyopathy increase the risk of adverse maternal, delivery, and neonatal outcomes in pregnant women?
Peripartum cardiomyopathy is associated with significantly increased risks of severe adverse maternal, delivery, and neonatal outcomes, including maternal and fetal death.
IMPORTANCE: Peripartum cardiomyopathy (PPCM) is a rare but potentially life-threatening form of heart failure affecting women during late pregnancy or early postpartum. Its impact on maternal, delivery, and neonatal outcomes remains understudied, highlighting the need for comprehensive research. OBJECTIVE: To determine the effects of PPCM during pregnancy on maternal, delivery, and neonatal outcomes using a large, contemporary nationwide database. DESIGN: Retrospective analysis of a population-based cohort using the Healthcare Cost and Utilisation Project Nationwide Inpatient Sample (HCUP-NIS) database from 2004 to 2014. SETTING: Hospital inpatient stays across 48 states and the District of Columbia in the United States. PARTICIPANTS: 9,096,788 pregnant women who delivered or had a maternal death, including 2127 diagnosed with PPCM. EXPOSURES: Diagnosis of peripartum cardiomyopathy during or after pregnancy, identified using ICD-9 diagnosis code 674.5x. MAIN OUTCOMES AND MEASURES: Women with PPCM had significantly higher rates of pregnancy-induced hypertension, preeclampsia, eclampsia, caesarean delivery, postpartum haemorrhage, and maternal death compared to those without PPCM. Delivery outcomes showed increased rates of preterm delivery, chorioamnionitis, and wound complications among PPCM patients. Neonatal outcomes revealed higher incidences of intrauterine foetal death and congenital anomalies in offspring of women with PPCM. Demographic and clinical characteristics associated with PPCM included advanced maternal age, African American race, obesity, chronic hypertension, previous caesarean section, smoking during pregnancy, and pregestational diabetes.
Samuels et al. (Tue,) studied this question.