Subsequent pregnancies in women with peripartum cardiomyopathy tied to adverse events

Subsequent pregnancies (SSPs) may lead to adverse outcomes in women with peripartum cardiomyopathy (PPCM), reveals a study, noting that the normalization of left ventricular function is not an assurance for a positive outcome in SSPs.

A team of investigators conducted a retrospective review of 137 PPCMs in the registry to assess the long-term survival of SSPs in this population. They then compared the clinical and echocardiographic findings between the recovery group and nonrecovery group, which were defined as left ventricular ejection fraction ≥50 percent and <50 percent, respectively, after an index of pregnancy.

Forty-five women with SSPs (mean age 27.0 years) were included in the study, of which 80 percent were African American and 75.6 percent came from a low socioeconomic background. Majority of these patients (n=30, 66.7 percent) were included in the recovery group.

SSPs significantly correlated with a decrease in mean left ventricular ejection fraction (from 45.1 percent to 41.2 percent; p=0.009).  Adverse outcomes at 5 years occurred more frequently among women in the nonrecovery group compared with those in the recovery group (53.3 percent vs 20.0 percent; p=0.04), driven by relapse PPCM (53.3 percent vs 20.0 percent; p=0.03).

Notably, all-cause mortality at 5 years was greater in the nonrecovery group than in the recovery group (13.33 percent vs 3.33 percent; p=0.25). However, adverse outcomes (53.3 percent vs 33.3 percent; p=0.20) and all-cause mortality rates (20 percent vs 20 percent) were comparable between the two groups at a median follow-up of 8 years.