Abstract 18151: Impact of Socioeconomic Disparities in Women With Peripartum Cardiomyopathy

Abstract

BACKGROUND Peripartum cardiomyopathy(PPCM) is a rare cardiomyopathy associated with pregnancy. Recently there is increased awareness of social determinants and health impact on cardiovascular disease. Hypothesis: We aim to investigate incidence, complication, and prognosis of PPCM in socioeconomically vulnerable South Bronx community and compare it with contemporary data. METHOD A retrospective cohort study was performed from 2009 to 2023 at a single center, BronxCare Health System in United States. A community hospital is located in South Bronx, a low socioeconomic neighborhood where median income is 57th percentile($15,398). South Bronx ethnicity was reported as 34% Black, 60% Hispanic. Statistics for numerical variables were presented as mean±SD and categorical variables were presented as count. Total subjects 52 were identified. After adopting criteria of systolic dysfunction with left ventricular ejection fraction(EF)<45%, 27 patients were included in PPCM group in our study consisting of 14 Black and 13 Hispanic women. RESULT The incidence of PPCM in our study was 1 in 622 live births compared to the incidence of PPCM in the United States 1 in 3,186 live births.(RR=5.12) MAE defined as mortality, heart transplant, mechanical circulatory support, pulmonary edema, thromboembolism, implantable cardioverter defibrillator implantation and cardiogenic shock, occurred in 29.6% compared to 13.5% of patients in a nationwide population-based study.(RR= 6.985) Follow-up echocardiogram in 5 years, 5 patients(18%) recovered their ejection fraction>45%, 11 patients (40%) did not recover, and the other 11(40%) were lost to follow-up, and repeat EF is unknown. 17 patients (62.9%) were counseled contraception. 4 patients had subsequent pregnancy, only 2 had recovered EF prior to subsequent pregnancy. CONCLUSION We observed the significant burden of PPCM in low-socioeconomic South Bronx community, higher incidence, and greater risk of adverse events compared to the nationwide population-based study. Healthcare professionals should be alert and emphasize the importance of close follow-up, patient education, and social support for PPCM patients to prevent complications and improve prognosis to decrease socioeconomic disparity impact on PPCM.