Position Statement

European Journal of Heart Failure, 2019
A position statement lets people know where a person or group stands on a topic or a debate. The Heart Failure Association of the European Society of Cardiology Study Group on Peripartum Cardiomyopathy published a position statement on PPCM in June 2019. The document discusses this group’s understanding and interpretation of contemporary research on the cause(s), diagnosis, treatment and prognosis of PPCM. Many of the recommendations included in this position statement are based on the opinions of European cardiologists with expertise in PPCM or on results of studies including only small numbers of women. Many PPCM experts in the United States hold differing views and offer slightly different approaches to the diagnosis and management of patients with PPCM, but this paper provides a broad overview of current knowledge of PPCM.

Cause

Heart, 2019
Small studies have previously shown that some women with PPCM have relatives with heart failure. This study looked at 48 women with PPCM in Denmark and compared their family histories with family histories of 477 Danish women who gave birth during the same time period. The women with PPCM more often had first degree relatives (birth parents, blood brothers, and sisters) with heart failure than the women without PPCM, suggesting that there might be a common cause for PPCM and other forms of heart failure.

Diagnosis

Clinical Cardiology, 2019
The Investigations in Pregnancy Associated Cardiomyopathy (IPAC) study was a National Institutes of Health (NIH) funded study of 100 women with newly diagnosed PPCM conducted in the United States and Canada between 2009-2012. The IPAC investigators have published a number of papers related to their research. This study examined the electrocardiograms (ECGs) of women with newly diagnosed PPCM. Half of the women had an abnormal ECG at the time of diagnosis, while the other half had a normal ECG. Women with a normal ECG at diagnosis had a better prognosis.

Support

Midwifery, 2019
Family members of women diagnosed with PPCM are affected by the diagnosis in varying ways. Fathers of children born to PPCM moms seem to be particularly affected by the diagnosis. These researchers interviewed 14 fathers whose partner was diagnosed with PPCM before or after giving birth. The first reaction in fathers was shock, followed by a wide range of other emotions. The authors conclude that emotional support for fathers is equally as important as the support required for mothers.

Prognosis

Archives of Cardiovascular Disease, 2019
Death is a feared complication of PPCM. Estimates of risk of death for women with PPCM have significantly varied over the years and among women in different countries. This study compared death rates among women in advanced (22 studies) versus developing (24 studies) countries. Overall mortality was 9%. Not surprisingly, the mortality rate in developing countries was higher (14%) than in advanced countries (4%). The risk of death was particularly increased in women of African descent.