What is the clinical evidence from this study?

Study design: Meta-Analysis. Population: Peripartum cardiomyopathy (n=13081388). Intervention: Black race vs. White race. Primary outcome: Overall mortality (p=0.013).

What does this research mean for the field?

Black women with peripartum cardiomyopathy experience significantly higher mortality and lower rates of ejection fraction recovery compared to White women. Novelty: ClaimNovelty.SYNTHESIS. Consensus alignment: ConsensusAlignment.NEUTRAL.

March 16, 2026JACC AdvancesOpen Access

Racial Disparities in U.S. Peripartum Cardiomyopathy

Q: What are the key findings of this study?

Black women with peripartum cardiomyopathy experienced significantly higher mortality (8.4% vs 2.4%) and lower ejection fraction recovery compared to White women.

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Key result

Peripartum cardiomyopathy in Black women linked to ~3.5-fold higher mortality vs White women.

P=0.013
n=13,081,388

Why the study?

Black women are disproportionately affected by PPCM and experience worse outcomes compared with other groups, prompting quantification of risk factor and outcome differences between Black and White women in the US.

Do Black women with peripartum cardiomyopathy experience worse outcomes and have different risk factor profiles compared to White women?

Study Design

Type

Meta-Analysis (n=13,081,388)

Multicenter

Yes

Structured PICO

Do Black women with peripartum cardiomyopathy experience worse outcomes and have different risk factor profiles compared to White women?

Population

12,502 Black and White U.S. women diagnosed with peripartum cardiomyopathy, along with 13,068,886 healthy controls, followed for up to 76 months.

Exposure

Black race (observational exposure)

Comparator

White race (observational exposure)

Outcome

Mortality from any causehard clinical

Main Result

Absolute Event Rate: 8.4% vs 2.4%

p-value: p=0.013

Despite having modest differences in previously identified cardiovascular risk factors, Black women with peripartum cardiomyopathy face significantly lower rates of left ventricular function recovery and over a three-fold higher mortality risk compared to White women.

Limitations

High statistical heterogeneity across included studies
Variability in definitions of ejection fraction recovery and diabetes timing
Reliance on medical record data and self-reported race
Inability to fully adjust for sociodemographic factors, education, and access to care
Institutional bias due to all studies taking place in academic centers
Small sample sizes in some subgroup analyses limiting generalizability
Use of aggregate data rather than individual data
Statistical heterogeneity and variable reporting between studies
Small sample sizes for specific subsets like medication outcomes
Most studies used electronic medical record data where race was self-reported
Limited data regarding specific event outcomes such as ICD or LVAD placement

Implication

May warrant intensified surveillance for Black women with peripartum cardiomyopathy; reinforces documented racial disparities and supports equity-focused prospective studies.

Abstract

BACKGROUND: Peripartum cardiomyopathy (PPCM) is a leading cause of heart failure in pregnancy and contributes significantly to maternal morbidity and mortality. Black women are disproportionately affected and experience worse outcomes compared with other groups. OBJECTIVES: This study aimed to quantify differences in risk factors and outcomes between Black and White women in the United States diagnosed with PPCM. METHODS: statistics were utilized for analysis. RESULTS: Compared with controls, cases had higher rates of obesity, preeclampsia, hypertension, diabetes, multiple gestations, and tobacco use. Compared to White cases, Black cases had higher prevalence of diabetes (14% vs 5%; P = 0.027) and utilization of public payer (72% vs 30%; P < 0.001). At presentation, mean left ventricular ejection fraction was 26% in Black women and 29% in White women. White women experienced higher rates of recovery in ejection fraction (63% vs 40%; P < 0.0001). Mortality rates were higher among Black women (8% vs 2%; P = 0.013). CONCLUSIONS: Black women with PPCM experienced lower recovery and higher mortality rates compared with White women. With the exception of a significant difference in payer status, modest differences in previously identified risk factors were observed between racial groups to account for worse outcomes (Disparities in risk factors and outcomes between Black and White US women with peripartum cardiomyopathy: A systematic review and meta-analysis; CRD42023439228).

Discussion

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Published by JACC Advances · CC BY

Cite This Study

Hermans et al. (2026) conducted a meta-analysis in Peripartum cardiomyopathy (n=13,081,388). Black race vs. White race was evaluated on Overall mortality (p=0.013). Black women with peripartum cardiomyopathy experienced significantly higher mortality (8.4% vs 2.4%) and lower ejection fraction recovery compared to White women.

synapsesocial.com/papers/6a07e297416812afca06e5ce https://doi.org/10.1016/j.jacadv.2026.102653

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Implication

May warrant intensified surveillance for Black women with peripartum cardiomyopathy; reinforces documented racial disparities and supports equity-focused prospective studies.

Racial Disparities in U.S. Peripartum Cardiomyopathy

Study Design

Structured PICO

Main Result

Limitations

Implication

Abstract

Discussion

Figures from the paper

Cite This Study

Racial Disparities in U.S. Peripartum Cardiomyopathy

Study Design

Structured PICO

Main Result

Limitations

Implication

Abstract

Discussion

Figures from the paper

Cite This Study

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