Heart failure & cardiomyopathiesSecondary analysis
Pregnancies in women after peri-partum cardiomyopathy: the global European Society of Cardiology EuroObservational Research Programme Peri-Partum Cardiomyopathy Registry
- Registry-based prospective cohort sub-study
- sub-study of the global ESC EORP PPCM Registry
- 2012–2023
- Median follow-up 198 days (IQR 160-240) from end of SSP
Authors' conclusion
Maternal morbidity and mortality rates were lower than anticipated. Baseline LVEF <50% was not associated with an increased frequency of adverse maternal outcomes, and no further decline in LVEF was observed in this group.
Study context
- Population
- Women with peri-partum cardiomyopathy (PPCM) undergoing subsequent pregnancies (SSPs)98 SSPs among 73 women
- Participants
- 332 participants
- Comparison
- SSP baseline left ventricular ejection fraction (LVEF) <50% vs LVEF ≥50%
- Primary endpoint
- Maternal and neonatal outcomes of SSPs; clinical worsening (all-cause death, CV rehospitalization, or LVEF decline ≥10 points and to <50%)
Primary result
As reported in the abstract
Maternal outcomes of SSPs
- Clinical worsening
- 20%
- All-cause maternal mortality
- 2%
- Signs/symptoms of HF
- 26%
- Worsening NYHA class
- 22%
- Mean LVEF at follow-up
- 50% (±12%)
- LVEF ≥50% at follow-up
- 69%
Further findings
SSPs ended prematurely
- SSPs ended prematurely
- 25 (26%)
- Therapeutic termination
- 20/25
- Miscarriage
- 4/25
- Stillbirth
- 1/25
Pre-SSP LVEF
- LVEF persistently <50% prior to SSP
- 26%
- LVEF <40% prior to SSP
- 6%
Neonatal outcomes
- Pre-term delivery
- 24%
- Low birth weight
- 20%
- All-cause neonatal mortality
- 3%
By SSP baseline LVEF
- Fewer women with LVEF ≥50% on HF pharmacotherapies prior to SSP, and a significant decline in LVEF in this group
By ethnicity
- African women had similar outcome as the other ethnic groups
Original publication
Pregnancies in women after peri-partum cardiomyopathy: the global European Society of Cardiology EuroObservational Research Programme Peri-Partum Cardiomyopathy Registry. Eur Heart J. Published 12 February 2025. doi:10.1093/eurheartj/ehaf006
Summarised from the published abstract; every number is checked against it