Heart failure & cardiomyopathiesCohort study
Impact of pregnancy on the natural history of women with hypertrophic cardiomyopathy
- Retrospective cohort study
Authors' conclusion
Pregnancy is not a modifier of long-term outcome in women with HCM and mostly occurs before a cardiac diagnosis.
Study context
- Population
- Women with hypertrophic cardiomyopathy (HCM), 1970–2021, with pregnancy information and follow-up ≥1 year
- Participants
- 379 women · 432 pregnancies
- Exposure
- Pregnancy vs no pregnancy
- Pregnancyn = 242
- Outcome
- MACE:
- CV death
- SCD
- Appropriate defibrillator shock
- Heart failure (HF) progression
Main finding
MACE · 10 ± 9 years of follow-up
Hazard ratio
0.605
95% CI 0.380–0.963
P = 0.034
Pregnancy vs No pregnancy
HR 0.605 (95% CI 0.380–0.963); P = 0.034
As reported in the abstract
Observational data: associations, not effects.
Further findings
| Outcome | HR (95% CI) | P value | |
|---|---|---|---|
| Predictors of MACE · 10 ± 9 years of follow-up — Age at diagnosis vs No pregnancy | 1.034 (1.018–1.050) | P < 0.001 | |
| Predictors of MACE · 10 ± 9 years of follow-up — NYHA II vs NYHA I | 1.944 (0.896–4.218) | ||
| Predictors of MACE · 10 ± 9 years of follow-up — NYHA III vs NYHA I | 5.291 (2.392–11.705) | P < 0.001 | |
| 0.050.21520Hazard ratio (log scale) |
Multiple pregnancies (among women with pregnancy)
- Multiple occurrences did not modify risk
Safety
Peri-partum MACE in pregnancies after HCM diagnosis · peri-partum (−1 to 6 months after delivery)
- Women with pregnancies after HCM diagnosis (39 pregnancies)
- 29 (7.6%)
- MACE in peri-partum period, all carrying likely pathogenic sarcomeric variants
- 3
Original publication
Impact of pregnancy on the natural history of women with hypertrophic cardiomyopathy. Eur J Prev Cardiol. Published 2 August 2023. doi:10.1093/eurjpc/zwad257
Summarised from the published abstract; every number is checked against it