Cardiomyopathy
Frequency of Peripartum Cardiomyopathy

https://doi.org/10.1016/j.amjcard.2006.01.039Get rights and content

Reports from case series have estimated the incidence of peripartum cardiomyopathy (PC) at 1 case/1,485 live births to 1 case/15,000 live births and probable mortality rates of 7% to 60%. The objective of this study was to produce the first population-based study of the incidence, mortality, and risk factors for PC. The National Hospital Discharge Survey was used. Discharge information was available for 3.6 million patient discharges from 1990 to 2002. There were an estimated 16,296 cases of PC from 1990 to 2002. During this period, there were 51,966,560 live births in the United States. Thus, the incidence of PC was 1 case/3,189 live births. There was a trend toward an increase in PC incidence during the study period, with an estimate for the years 2000 to 2002 of 1 case/2,289 live births. The in-hospital mortality rate was 1.36% (95% confidence interval 0% to 10.2%). The total mortality rate was 2.05% (95% confidence interval 0.29% to 10.8%). Patients with PC were older (mean age 29.7 vs 26.9 years), were more likely to be black (32.2% vs 15.7%), and had a higher incidence of pregnancy associated hypertensive disorders (22.5% vs 5.87%) compared with national data. In conclusion, the incidence of PC is relatively uncommon, occurring at an average frequency of 1 case/3,189 live births from 1990 to 2002. The estimated mortality of 1.36% to 2.05% (95% confidence interval 0.29% to 10.8%) is less than previously reported from most case series.

Section snippets

Database

The National Hospital Discharge Survey (NHDS) has been conducted continuously by the National Center for Health Statistics since 1965.13 The National Center for Health Statistics obtains a nationally representative sample of discharge records from hospitals in the United States. On average, 464 hospitals are selected, and 265,000 to 270,000 records are abstracted annually, representing about 1% of all discharges from nonfederal, short-stay hospitals in the United States. A 3-stage probability

Number of records abstracted

Discharge information was available for 3.6 million patient discharges for the years 1990 to 2002 inclusive. One thousand five hundred twenty-seven of these 3.6 million discharges had a discharge diagnostic code of 674.8. Each of these cases was evaluated in detail according to the strict criteria detailed previously, and a total of 171 sample cases of PC were included for the analysis.

PC incidence estimates

Incorporating the individual sample case weights resulted in an estimate of 16,296 cases of PC from 1990 to

Discussion

PC is defined as the development of heart failure in the last month of pregnancy or the first 5 months after delivery. Additional diagnostic criteria have been suggested to increase the specificity of this disorder. These include the absence of an identifiable cause of heart failure, no known previous cardiac disease, and objective evidence of left ventricular systolic dysfunction.3 Little is known about the epidemiology and prognosis of PC. We believe that this is the first population-based

References (26)

  • G.D. Pearson et al.

    Peripartum cardiomyopathyNational Heart, Lung, and Blood Institute and Office of Rare Diseases (National Institutes of Health) workshop recommendations and review

    JAMA

    (2000)
  • F.G. Cunningham et al.

    Peripartum heart failureidiopathic cardiomyopathy or compounding cardiovascular events?

    Obstet Gynecol

    (1986)
  • U. Elkayam et al.

    Pregnancy-associated cardiomyopathyclinical characteristics and a comparison between early and late presentation

    Circulation

    (2005)

    • Cited by (0)

    View full text
    Copyright © 2006 Elsevier Inc. All rights reserved.