A Population-based Study of Peripartum Cardiomyopathy in Southern Israel: Are Bedouin Women a New High-risk Group?
Objectives Peripartum cardiomyopathy (PPCM) is a serious complication of pregnancy. Studies investigating the risk factors that worsen outcomes have yielded conflicting results. The goals of this study were to describe the clinical and echocardiographic characteristics of PPCM in a single tertiary...
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| Format: | Article |
| Language: | English |
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Rambam Health Care Campus
2018-04-01
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| Series: | Rambam Maimonides Medical Journal |
| Subjects: | |
| Online Access: | https://www.rmmj.org.il/issues/37/817/manuscript |
| _version_ | 1818035408148103168 |
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| author | Louise Kezerle Iftach Sagy Leah Shalev Offer Erez Leonid Barski |
| author_facet | Louise Kezerle Iftach Sagy Leah Shalev Offer Erez Leonid Barski |
| author_sort | Louise Kezerle |
| collection | DOAJ |
| description | Objectives
Peripartum cardiomyopathy (PPCM) is a serious complication of pregnancy. Studies investigating the risk factors that worsen outcomes have yielded conflicting results. The goals of this study were to describe the clinical and echocardiographic characteristics of PPCM in a single tertiary center and to determine the prognostic factors associated with persistence of left ventricular (LV) dysfunction in these women.
Study Design
This retrospective cross-sectional population-based cohort study included all patients with PPCM confirmed by echocardiography who delivered at our center from 2004 to 2014. Two groups were compared to determine long-term maternal outcome: (1) those who recovered normal LV function; and (2) those with residual systolic LV dysfunction.
Results
There were 148,994 deliveries during the study period. Of these, 89,196 patients were Bedouin and 59,798 were non-Bedouin. Forty-six patients met the PPCM study inclusion criteria. The PPCM prevalence for the total deliveries was 1:3,239. The PPCM prevalence among Bedouin patients was 1:2,787 versus non-Bedouin patients of 1:4,983 (P=0.037). None of the women had pre-existing chronic hypertension, and there was no maternal death. Patients who had severe or moderate LV dysfunction at the clinical presentation of PPCM were less likely to regain normal LV function than those with mild dysfunction (81.2% versus 56.7%, P=0.009). Based on initial echocardiogram, a trend toward residual LV dysfunction was noted in patients with a dilated left ventricle as compared to those with a non-dilated left ventricle (18.8% versus 6.7%, P=0.32). A hypokinetic right ventricle was found in 15.2% of the women who suffered from PPCM.
Conclusion
In our cohort, Bedouin women may be at increased risk for PPCM, and patients with severe LV dysfunction have a lower chance of recovery from PPCM. |
| first_indexed | 2024-12-10T06:54:35Z |
| format | Article |
| id | doaj.art-f238ec88262e456482b56b922037579b |
| institution | Directory Open Access Journal |
| issn | 2076-9172 |
| language | English |
| last_indexed | 2024-12-10T06:54:35Z |
| publishDate | 2018-04-01 |
| publisher | Rambam Health Care Campus |
| record_format | Article |
| series | Rambam Maimonides Medical Journal |
| spelling | doaj.art-f238ec88262e456482b56b922037579b2022-12-22T01:58:29ZengRambam Health Care CampusRambam Maimonides Medical Journal2076-91722018-04-0192e001110.5041/RMMJ.10331A Population-based Study of Peripartum Cardiomyopathy in Southern Israel: Are Bedouin Women a New High-risk Group?Louise Kezerle0Iftach Sagy1Leah Shalev2Offer Erez3Leonid Barski4Department of Internal Medicine “F,” Soroka University Medical Center, Beersheva, IsraelDepartment of Internal Medicine “F,” Soroka University Medical Center, Beersheva, Israel and Clinical Research Center, Soroka University Medical Center, Beersheva, IsraelDepartment of Internal Medicine “F,” Soroka University Medical Center, Beersheva, IsraelDepartment of Obstetrics “D,” Soroka University Medical Center, Beersheva, IsraelDepartment of Internal Medicine “F,” Soroka University Medical Center, Beersheva, IsraelObjectives Peripartum cardiomyopathy (PPCM) is a serious complication of pregnancy. Studies investigating the risk factors that worsen outcomes have yielded conflicting results. The goals of this study were to describe the clinical and echocardiographic characteristics of PPCM in a single tertiary center and to determine the prognostic factors associated with persistence of left ventricular (LV) dysfunction in these women. Study Design This retrospective cross-sectional population-based cohort study included all patients with PPCM confirmed by echocardiography who delivered at our center from 2004 to 2014. Two groups were compared to determine long-term maternal outcome: (1) those who recovered normal LV function; and (2) those with residual systolic LV dysfunction. Results There were 148,994 deliveries during the study period. Of these, 89,196 patients were Bedouin and 59,798 were non-Bedouin. Forty-six patients met the PPCM study inclusion criteria. The PPCM prevalence for the total deliveries was 1:3,239. The PPCM prevalence among Bedouin patients was 1:2,787 versus non-Bedouin patients of 1:4,983 (P=0.037). None of the women had pre-existing chronic hypertension, and there was no maternal death. Patients who had severe or moderate LV dysfunction at the clinical presentation of PPCM were less likely to regain normal LV function than those with mild dysfunction (81.2% versus 56.7%, P=0.009). Based on initial echocardiogram, a trend toward residual LV dysfunction was noted in patients with a dilated left ventricle as compared to those with a non-dilated left ventricle (18.8% versus 6.7%, P=0.32). A hypokinetic right ventricle was found in 15.2% of the women who suffered from PPCM. Conclusion In our cohort, Bedouin women may be at increased risk for PPCM, and patients with severe LV dysfunction have a lower chance of recovery from PPCM.https://www.rmmj.org.il/issues/37/817/manuscriptEpidemiologyperipartum cardiomyopathyprognostic factors |
| spellingShingle | Louise Kezerle Iftach Sagy Leah Shalev Offer Erez Leonid Barski A Population-based Study of Peripartum Cardiomyopathy in Southern Israel: Are Bedouin Women a New High-risk Group? Rambam Maimonides Medical Journal Epidemiology peripartum cardiomyopathy prognostic factors |
| title | A Population-based Study of Peripartum Cardiomyopathy in Southern Israel: Are Bedouin Women a New High-risk Group? |
| title_full | A Population-based Study of Peripartum Cardiomyopathy in Southern Israel: Are Bedouin Women a New High-risk Group? |
| title_fullStr | A Population-based Study of Peripartum Cardiomyopathy in Southern Israel: Are Bedouin Women a New High-risk Group? |
| title_full_unstemmed | A Population-based Study of Peripartum Cardiomyopathy in Southern Israel: Are Bedouin Women a New High-risk Group? |
| title_short | A Population-based Study of Peripartum Cardiomyopathy in Southern Israel: Are Bedouin Women a New High-risk Group? |
| title_sort | population based study of peripartum cardiomyopathy in southern israel are bedouin women a new high risk group |
| topic | Epidemiology peripartum cardiomyopathy prognostic factors |
| url | https://www.rmmj.org.il/issues/37/817/manuscript |
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