Temporal trends in incidence and outcomes of peripartum cardiomyopathy in the United States: a nationwide population-based study.
Bottom Line: Mean length of stay decreased during the study period.Maternal MAE rates overall have remained unchanged while cardiogenic shock, utilization of mechanical circulatory support, and in-hospital mortality have increased during the study period.Further study of the mechanisms underlying these adverse trends in the incidence and outcomes of PPCM are warranted.
Affiliation: Department of Medicine, New York Medical College, Valhalla, NY (D.K., S.K., M.M.).Show MeSH
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Mentions: In the overall cohort, PPCM incidence rate increased significantly from 8.5 per 10 000 live births (1 in 1181 live births) in 2004 to 11.8 per 10 000 live births (1 in 849 live births) in 2011 (Ptrend<0.001) (Figure 1). A similar increase in PPCM rates were seen in women ≥20 years of age, in all racial/ethnic groups (except Hispanics and Asian/Pacific Islanders), and across all census regions in the United States during the study period (Ptrend<0.05 for all) (Tables 2 and 3). From 2004 to 2011, there was a significant increase in the incidence of PPCM in patients with chronic hypertension (219.7 to 295.7 per 10 000 live births, Ptrend<0.001) and diabetes mellitus (16.5 to 21.3 per 10 000 live births, Ptrend<0.001), but not in those with pregnancy‐associated hypertension or eclampsia (Table 2). As expected, based on current recommendations regarding avoidance of subsequent pregnancies after the development of PPCM, the rates of PPCM were higher among primipara women. Interestingly, women with multiple gestation pregnancies had a lower rate of PPCM (Table 2).
Affiliation: Department of Medicine, New York Medical College, Valhalla, NY (D.K., S.K., M.M.).