Safety of contraceptive use among women with peripartum cardiomyopathy: a systematic review.
METHODS
Women with peripartum cardiomyopathy (PPCM) have significant health risks during subsequent pregnancies and therefore have a critical need for safe and effective contraception. This systematic review examines evidence regarding the safety of contraceptive use among women with PPCM.


METHODS
We searched the PubMed database for all primary research articles published through February 2009 that addressed the safety of any contraceptive method among women with PPCM or other cardiomyopathy of any type.


RESULTS
Of 110 articles that addressed contraceptive safety among women with cardiac disease, three met our inclusion criteria. In these three studies, which included a total of five women with cardiomyopathy, though not specifically PPCM, cases of hypertension, transient ischemic attack (TIA), thromboembolism or heart failure were found among women with cardiac disease who used hormonal methods of contraception including combined oral contraceptives, progestin-only pills and depot medroxyprogesterone acetate. None of the studies reported any cases of cardiovascular complications or infective endocarditis among women with cardiac disease who used intrauterine devices (IUDs).


CONCLUSIONS
We found no data concerning the safety of contraceptive use among women with PPCM, though we did find limited evidence of hypertension, TIA, thromboembolism and heart failure among women with cardiac disease who used hormonal methods of contraception. None of the studies reported any cases of cardiovascular complications or infective endocarditis among women with cardiac disease who used IUDs.
Tepper
Naomi K
NK
Centers for Disease Control and Prevention, Atlanta, GA 30341, USA. ntepper@cdc.gov
Paulen
Melissa E
ME
Marchbanks
Polly A
PA
Curtis
Kathryn M
KM
D009202:Cardiomyopathies / Q000150:complications* / Q000517:prevention & control; D003267:Contraception / Q000009:adverse effects* / Q000379:methods; D003278:Contraceptives, Oral, Hormonal / Q000009:adverse effects; D005260:Female; D006333:Heart Failure / Q000453:epidemiology; D006801:Humans; D006973:Hypertension / Q000453:epidemiology; D007434:Intrauterine Devices / Q000009:adverse effects; D002546:Ischemic Attack, Transient / Q000453:epidemiology; D011247:Pregnancy; D011249:Pregnancy Complications, Cardiovascular / Q000517:prevention & control*; D039781:PubMed; D013923:Thromboembolism / Q000453:epidemiology
D003278:Contraceptives, Oral, Hormonal