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. 2024 Mar 1:398:131596.
doi: 10.1016/j.ijcard.2023.131596. Epub 2023 Nov 17.

Socio-economic factors determine maternal and neonatal outcomes in women with peripartum cardiomyopathy: A study of the ESC EORP PPCM registry

Karen Sliwa  1 , Peter van der Meer  2 , Charle Viljoen  3 , Alice M Jackson  4 , Mark C Petrie  4 , Alexandre Mebazaa  5 , Denise Hilfiker-Kleiner  6 , Aldo P Maggioni  7 , Cecile Laroche  8 , Vera Regitz-Zagrosek  9 , Luigi Tavazzi  10 , Jolien W Roos-Hesselink  11 , Righab Hamdan  12 , Alexandra Frogoudaki  13 , Bassem Ibrahim  14 , Hasan Ali Farhan Farhan  15 , Amam Mbakwem  16 , Petar Seferovic  17 , Michael Böhm  18 , Burkert Pieske  19 , Mark R Johnson  20 , Johann Bauersachs  21 ; EURObservational Research Programme, in conjunction with the Heart Failure Association of the European Society of Cardiology Study Group on Peripartum Cardiomyopathy
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Free article

Socio-economic factors determine maternal and neonatal outcomes in women with peripartum cardiomyopathy: A study of the ESC EORP PPCM registry

Karen Sliwa et al. Int J Cardiol. .
Free article

Abstract

Background: Peripartum cardiomyopathy (PPCM) is a global disease with substantial morbidity and mortality. The aim of this study was to analyze to what extent socioeconomic factors were associated with maternal and neonatal outcomes.

Methods: In 2011, >100 national and affiliated member cardiac societies of the European Society of Cardiology (ESC) were contacted to contribute to a global PPCM registry, under the auspices of the ESC EORP Programme. We investigated the characteristics and outcomes of women with PPCM and their babies according to individual and country-level sociodemographic factors (Gini index coefficient [GINI index], health expenditure [HE] and human developmental index [HDI]).

Results: 739 women from 49 countries (Europe [33%], Africa [29%], Asia-Pacific [15%], Middle East [22%]) were enrolled. Low HDI was associated with greater left ventricular (LV) dilatation at time of diagnosis. However, baseline LV ejection fraction did not differ according to sociodemographic factors. Countries with low HE prescribed guideline-directed heart failure therapy less frequently. Six-month mortality was higher in countries with low HE; and LV non-recovery in those with low HDI, low HE and lower levels of education. Maternal outcome (death, re-hospitalization, or persistent LV dysfunction) was independently associated with income. Neonatal death was significantly more common in countries with low HE and low HDI, but was not influenced by maternal income or education attainment.

Conclusions: Maternal and neonatal outcomes depend on country-specific socioeconomic characteristics. Attempts should therefore be made to allocate adequate resources to health and education, to improve maternal and fetal outcomes in PPCM.

Keywords: Ethnicity; Gini index; HDI; HE; Peripartum cardiomyopathy; Socio-economic factors.

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Conflict of interest statement

Declaration of Competing Interest None of the authors have any conflict of interest to declare related to this manuscript.

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