Impact of socioeconomic deprivation on outcomes in peripartum cardiomyopathy: A retrospective cohort study

BACKGROUND Peripartum cardiomyopathy disproportionately affects women experiencing socioeconomic disadvantage, yet the prognostic impact of deprivation within contemporary U.S. health systems remains uncertain. OBJECTIVE To evaluate whether socioeconomic deprivation independently influences 1-year clinical outcomes in patients with peripartum cardiomyopathy. STUDY DESIGN This retrospective cohort study used the TriNetX U.S. research network (2015-2024) to identify adults with peripartum cardiomyopathy. Socioeconomic deprivation was defined using validated ICD-10/HCPCS social risk codes. Patients were propensity score-matched (1:1) for demographics, comorbidities, medications, and laboratory values. Cox proportional hazards models estimated 12-month outcomes. RESULTS After 1:1 propensity score matching, 1,298 women were included in each cohort, with balanced baseline characteristics. At 12 months, socioeconomic deprivation was not associated with the primary composite outcome of all-cause mortality or hospitalization (HR 1.03; 95% CI 0.89-1.19; P=0.728), nor with either component individually. Socioeconomically deprived women had lower hazards of heart failure events (HR 0.82; 95% CI 0.73-0.93; P=0.001) and arrhythmia (HR 0.83; 95% CI 0.70-0.99; P=0.039). No significant differences were observed in thromboembolic events, new-onset thromboembolism, cardiogenic shock, or procedural outcomes. CONCLUSIONS In this large real-world U.S. cohort, socioeconomic deprivation did not worsen 1-year outcomes in peripartum cardiomyopathy, suggesting that access to high-quality, equitable care may attenuate socioeconomic disparities.