Temporal trends in cardiomyopathy in pregnancy and association with feto-infant morbidity outcomes

OBJECTIVE: To examine temporal trends of cardiomyopathy in pregnancy and its association with feto-infant morbidity outcomes. DESIGN AND METHODS: We performed a population-based retrospective cohort analysis utilizing the Florida hospital discharge data linked to vital statistics for 1998 to 2007 (N = 1 738 860). Prevalence rates and trend statistics of cardiomyopathy were computed. Conditional logistic regression models were used to generate adjusted odds ratios (AOR) and 95% confidence intervals (CI). RESULTS: The annual prevalence of cardiomyopathy in pregnancy increased from 8.5/100 000 births to 32.7/100 000 (p for trend <0.0001), representing an absolute increase of 24% and a relative increase of 300% over the decade. Infants born to women with cardiomyopathy were at higher risk for feto-infant morbidities, including low birth weight (AOR = 3.49, 95% CI: 2.97-4.11), very low birth weight (AOR = 4.43, 95% CI: 2.98-6.60), preterm birth (AOR = 3.33, 95% CI: 2.88-3.85), very preterm birth (AOR = 5.22, 95% CI: 3.92-6.97) and small for gestational age (AOR = 1.57, 95% CI: 1.26-1.96). CONCLUSION: The observed increasing prevalence of cardiomyopathy during pregnancy over the decade is of concern, as it is related to elevated risk for feto-infant morbidities. There is a need to delineate risk factors for this condition and to formulate appropriate preconception counseling for women with elevated risk for this diagnosis.