Epidemiology and outcomes of peripartum cardiomyopathy in the United States: Findings from the Nationwide Inpatient Sample

Parasuram Krishnamoorthy, Jalaj Garg, Chandrasekar Palaniswamy, Ambarish Pandey, Hasan Ahmad, William H. Frishman, Gregg Lanier

Research output: Contribution to journalArticle

12 Scopus citations

Abstract

Aims Peripartum cardiomyopathy (PPCM) is defined as systolic heart failure within the last month of pregnancy or 5 months after delivery in the absence of any identifiable cause of heart failure. We aimed to investigate the prevalence of PPCM and predictors of in-hospital mortality in patients with PPCM. Methods We analyzed patients with diagnosis of PPCM from the Nationwide Inpatient Sample database using the Ninth Revision of International Classification of Diseases (ICD-9) from 2009 to 2010. We categorized PPCM (nU4871) into three groups of presentation based on their ICD-9 codes: Antepartum (674.53; nU189), peripartum (674.51, 674.52; nU887) and postpartum (674.54; nU3741). Results PPCM was more common in African-Americans (43.9%) as compared with white (40.8%), Hispanic (8.7%) and Asian (2.7%) women. Hypertensive disorders were classified as pre-existing hypertension (31.6%), gestational hypertension (3.7%), preeclampsia (9.9%), eclampsia (2.4%) and preeclampsia/eclampsia superimposed on hypertension (3.1%). Among different ethnicities, preexisting hypertension (1 : 2.3) and diabetes (1 : 10.4) were more prevalent in African-Americans, whereas preeclampsia (1 : 4.3) and premature labor (1 : 5.4) were more common in Asians. In-hospital mortality rate was 1.8%, with 2.1% in the postpartum and 0.5% in the peripartum group. Asians had the highest mortality (8.3%). In multimodel regression analysis, Asians [odds ratio (OR) 9.68, 95% confidence interval (CI) 1.11-83.9, PU0.03] and length of stay (OR 1.06, 95% CI 1.03-1.10, P<0.01) were associated with increased mortality, whereas white women were associated with reduced mortality (OR 0.10, 95% CI 0.02-0.59, PU0.01). Conclusion Although PPCM was prevalent in African- Americans, Asians had higher in-hospital mortality, increased prevalence of preeclampsia and premature labor. Also, mortality rate was significantly higher in the postpartum group.

Original languageEnglish (US)
Pages (from-to)756-761
Number of pages6
JournalJournal of Cardiovascular Medicine
Volume17
Issue number10
DOIs
StatePublished - Jan 1 2016
Externally publishedYes

Keywords

  • epidemiology
  • mortality
  • outcomes
  • peripartum cardiomyopathy
  • preeclampsia
  • risk factors

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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