PERIPARTUM CARDIOMYOPATHY IN MANITOBA: ANALYSIS OF THE CLINICAL CHARACTERISTICS AND FEATURES ASSOCIATED WITH SEVERITY OF DISEASE

Abstract

Objectives Peripartum cardiomyopathy (PPCM) is a dilated cardiomyopathy with onset between the final month of pregnancy and five months postpartum. The purpose of this study was to analyze the clinical characteristics of adults with a diagnosis of PPCM in Manitoba. Methods We completed a retrospective review of 22 cases of PPCM identified using either PPCM ICD codes or a database of heart failure patients treated in Winnipeg from January 2005 to December 2015. Data collected included demographics, delivery information, clinical presentation, and associated conditions. We completed descriptive analysis and assessed for features correlated with more severe disease using Chi-Square and Wilcoxon rank tests. Results Our population had an average age 31.3 (SD ± 5.3), were multiparous, and at least 50% (11/22) were non-Caucasian with 41% (9/22) being Aboriginal or Inuit. The Cesarean section rate was 59% (13/22) and the average gestational age at delivery was 37.4 weeks (SD +/- 3.3). Forty-five percent (10/22) of patients had a diagnosis of hypertensive disorders of pregnancy (HDP) and a trend that those with HDP were more likely to have a left ventricular ejection fraction greater than 30% (p = 0.05). Conclusions Our findings are in keeping with known risk factors for PPCM, namely maternal age greater than 30years, multiparity, and history of HDP. Our study also suggest that PPCM on background of HDP have a less severe heart failure and that Aboriginal and Inuit patients with PPCM may be at higher risk. These areas warrant further study to explore the validity and significance of these results.