This research is Trending!
Heart Failure Occurring in the Perinatal Period: A Scientific Statement From the American Heart Association
Why the study?
Heart failure in the perinatal period remains ambiguous in definition and management, with unknown true incidence and diagnostic challenges that contribute to adverse maternal outcomes.
Key Points
- Perinatal heart failure remains difficult to identify due to typical pregnancy symptoms, even though adult population prevalence reaches 1% to 2%.
- Scientific statement outlines diagnostic thresholds and treatment standards for obstetric cardiomyopathy with reduced left ventricular ejection fraction.
- Standardization of clinical definitions and screening tools may enable earlier diagnosis, reducing maternal complications and advancing health equity.
Structured PICO
P
Population
Pregnant and postpartum individuals with heart failure (reduced and mildly reduced ejection fraction) caused by various forms of cardiomyopathy
This AHA scientific statement highlights the challenges in diagnosing perinatal heart failure and calls for standardized definitions, improved screening, and inclusion of pregnant individuals in clinical trials.
Key expert perspectives
Captured external expert commentary on this paper, strongest first. Original sources are linked where available.
“Heart failure during and after pregnancy is often hiding in plain sight. By recognizing symptoms earlier and initiating appropriate treatment, especially in the postpartum period, clinicians and health systems have a powerful opportunity to prevent serious complications and save mothers' lives.”
Dr. Demilade A. AdedinsewoChair of the volunteer scientific statement writing group and Assistant Professor of Cardiovascular Medicine“Heart failure affects more than just the heart—it can affect the lungs, kidneys, brain and more. Because blood flow is reduced and fluid builds up, it can lead to breathing difficulties, kidney issues, irregular heartbeats and increased risk of stroke and death.”
Dr. Demilade A. AdedinsewoChair of the volunteer scientific statement writing group and Assistant Professor of Cardiovascular Medicine“one of the main challenges is that symptoms of heart failure such as shortness of breath fatigue or low extremity swelling often overlaps with normal pregnancy symptoms. and in this case it can lead to delays in diagnosis. and also delays in time to start inappropriate therapy as a result heart failure in pregnant and postpartum individuals is often hiding in plain sight is how I would put it.”
Implication
May inform perinatal HF care via expert consensus; leaves open standardized definitions and screening tools.
Abstract
Heart failure in the perinatal period remains ambiguous in definition and management despite its recognition as a unique disease state. The true incidence and prevalence of heart failure or left ventricular systolic dysfunction during pregnancy and the postpartum period are unknown, although a prevalence as high as 1% to 2% has been reported in the general adult US population. Assessment of heart failure can be challenging in the pregnant or postpartum state, during which symptoms affecting physical function (eg, dyspnea, exercise intolerance, fatigue, and lower-extremity edema) are prevalent because of physiological changes. Delays in the recognition and diagnosis of heart failure during the perinatal period contribute to adverse maternal outcomes, highlighting the need for evidence-based definitions and thresholds, improved diagnostic criteria to aid disease recognition, and effective screening tools. This scientific statement focuses on heart failure with reduced and mildly reduced ejection fraction in the context of pregnancy and the postpartum period, caused by various forms of cardiomyopathy. It addresses challenges related to recognizing heart failure in obstetric patients, outlines established treatment standards, and underscores potential areas for research. To improve the management of preexisting and de novo heart failure in obstetric patients, standardization of disease definitions, specific therapeutic options, implementation of effective screening tools, and interventions to improve maternal health equity are imperative. Future directions include prioritizing the inclusion of pregnant and postpartum individuals in heart failure studies, implementing interventions that facilitate early disease detection, and ensuring the timely initiation of appropriate therapies with the goal of reducing adverse outcomes associated with perinatal heart failure.
Discussion
No takes yet. Share an insight, caveat, or question.
Cite This Study
Adedinsewo et al. (2026) conducted a review in Heart failure in the perinatal period. This scientific statement outlines established treatment standards and underscores the need for standardized definitions and effective screening tools for perinatal heart failure.