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Incidence, Risk Factors, Maternal and Neonatal Outcomes of Peripartum Cardiomyopathy (PPCM) in Oman

BACKGROUND: Peripartum cardiomyopathy (PPCM) is an idiopathic life-threatening condition occurring towards the end of pregnancy or in the first few months following delivery that might affect the maternal and neonatal outcomes. OBJECTIVES: To assess the incidence and to evaluate the antenatal risk f...

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Autores principales: Al Riyami, Nihal, Al Khayari, Safa, Al Zadjali, Riham, Machado, Lovina, Al Madhani, Alya, Al Lawati, Hatim
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Ubiquity Press 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10162354/
https://www.ncbi.nlm.nih.gov/pubmed/37153846
http://dx.doi.org/10.5334/gh.1198
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author Al Riyami, Nihal
Al Khayari, Safa
Al Zadjali, Riham
Machado, Lovina
Al Madhani, Alya
Al Lawati, Hatim
author_facet Al Riyami, Nihal
Al Khayari, Safa
Al Zadjali, Riham
Machado, Lovina
Al Madhani, Alya
Al Lawati, Hatim
author_sort Al Riyami, Nihal
collection PubMed
description BACKGROUND: Peripartum cardiomyopathy (PPCM) is an idiopathic life-threatening condition occurring towards the end of pregnancy or in the first few months following delivery that might affect the maternal and neonatal outcomes. OBJECTIVES: To assess the incidence and to evaluate the antenatal risk factors and the maternal and neonatal outcomes in Omani women diagnosed with PPCM. METHODS: A retrospective cohort study was conducted at two tertiary institutions in Oman between the 1(st) of January 2010 to the 31(st) of December 2018. All cases fitting the standard definition of PPCM were included in the analysis. Patients with pre-existing dilated cardiomyopathy, chronic obstructive pulmonary disease and significant valvular heart disease have been excluded. RESULTS: A total of 113,104 deliveries were screened during the study period. PPCM was confirmed in 116 cases with an incidence of 1.02 per 1000 deliveries. Independent predictors for the development of PPCM were age; especially women at the mid reproductive age (26–35 years), singleton pregnancy and gestational hypertension. In general, maternal outcomes were favorable, with full recovery of left ventricular ejection fraction in 56.0%, recurrence of 9.2%, and an overall mortality rate of 3.4%. The most common maternal complication was pulmonary edema (16.3%). The neonatal mortality rate was 4.3% and the preterm birth rate was 35.7%. Neonatal outcomes included 94.3% live births, out of which 64.3% were term with Apgar scores of more than 7 at five minutes in 91.5% of the neonates. CONCLUSION: Our study resulted in an overall incidence of PCCM in Oman of 1.02 in 1000 deliveries. Given the significance of maternal and neonatal complications, establishing a national PPCM database and local practice guidelines, and emphasizing their implementations in all regional hospitals, are fundamental for early recognition of the disease, timely referral, and application of therapy. Future studies, with a clearly defined control group, are highly recommended to appraise the significance of antenatal comorbidities in PPCM compared to non-PPCM cases.
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spelling pubmed-101623542023-05-06 Incidence, Risk Factors, Maternal and Neonatal Outcomes of Peripartum Cardiomyopathy (PPCM) in Oman Al Riyami, Nihal Al Khayari, Safa Al Zadjali, Riham Machado, Lovina Al Madhani, Alya Al Lawati, Hatim Glob Heart Original Research BACKGROUND: Peripartum cardiomyopathy (PPCM) is an idiopathic life-threatening condition occurring towards the end of pregnancy or in the first few months following delivery that might affect the maternal and neonatal outcomes. OBJECTIVES: To assess the incidence and to evaluate the antenatal risk factors and the maternal and neonatal outcomes in Omani women diagnosed with PPCM. METHODS: A retrospective cohort study was conducted at two tertiary institutions in Oman between the 1(st) of January 2010 to the 31(st) of December 2018. All cases fitting the standard definition of PPCM were included in the analysis. Patients with pre-existing dilated cardiomyopathy, chronic obstructive pulmonary disease and significant valvular heart disease have been excluded. RESULTS: A total of 113,104 deliveries were screened during the study period. PPCM was confirmed in 116 cases with an incidence of 1.02 per 1000 deliveries. Independent predictors for the development of PPCM were age; especially women at the mid reproductive age (26–35 years), singleton pregnancy and gestational hypertension. In general, maternal outcomes were favorable, with full recovery of left ventricular ejection fraction in 56.0%, recurrence of 9.2%, and an overall mortality rate of 3.4%. The most common maternal complication was pulmonary edema (16.3%). The neonatal mortality rate was 4.3% and the preterm birth rate was 35.7%. Neonatal outcomes included 94.3% live births, out of which 64.3% were term with Apgar scores of more than 7 at five minutes in 91.5% of the neonates. CONCLUSION: Our study resulted in an overall incidence of PCCM in Oman of 1.02 in 1000 deliveries. Given the significance of maternal and neonatal complications, establishing a national PPCM database and local practice guidelines, and emphasizing their implementations in all regional hospitals, are fundamental for early recognition of the disease, timely referral, and application of therapy. Future studies, with a clearly defined control group, are highly recommended to appraise the significance of antenatal comorbidities in PPCM compared to non-PPCM cases. Ubiquity Press 2023-05-02 /pmc/articles/PMC10162354/ /pubmed/37153846 http://dx.doi.org/10.5334/gh.1198 Text en Copyright: © 2023 The Author(s) https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution 4.0 International License (CC-BY 4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. See http://creativecommons.org/licenses/by/4.0/.
spellingShingle Original Research
Al Riyami, Nihal
Al Khayari, Safa
Al Zadjali, Riham
Machado, Lovina
Al Madhani, Alya
Al Lawati, Hatim
Incidence, Risk Factors, Maternal and Neonatal Outcomes of Peripartum Cardiomyopathy (PPCM) in Oman
title Incidence, Risk Factors, Maternal and Neonatal Outcomes of Peripartum Cardiomyopathy (PPCM) in Oman
title_full Incidence, Risk Factors, Maternal and Neonatal Outcomes of Peripartum Cardiomyopathy (PPCM) in Oman
title_fullStr Incidence, Risk Factors, Maternal and Neonatal Outcomes of Peripartum Cardiomyopathy (PPCM) in Oman
title_full_unstemmed Incidence, Risk Factors, Maternal and Neonatal Outcomes of Peripartum Cardiomyopathy (PPCM) in Oman
title_short Incidence, Risk Factors, Maternal and Neonatal Outcomes of Peripartum Cardiomyopathy (PPCM) in Oman
title_sort incidence, risk factors, maternal and neonatal outcomes of peripartum cardiomyopathy (ppcm) in oman
topic Original Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10162354/
https://www.ncbi.nlm.nih.gov/pubmed/37153846
http://dx.doi.org/10.5334/gh.1198
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