title: Characteristics, adverse events, and racial differences among delivering mothers with peripartum cardiomyopathy.
abstract: OBJECTIVE
  The aim of this study was to identify clinical features associated with peripartum cardiomyopathy (PPCM) and possible racial differences and to quantify in-hospital outcomes in delivering mothers with PPCM.
  
  
  BACKGROUND
  Investigation of patient characteristics and outcomes in PPCM has been limited to small cohorts. Hospital discharge data allow assembly of the largest number of PPCM cases to date.
  
  
  METHODS
  Hospital records from 6 states were screened for PPCM. Clinical profiles, maternal, and fetal outcomes in delivering mothers with and without PPCM were compared and stratified by race. A maternal major adverse event (MAE) was defined as death, cardiac arrest, heart transplantation, or mechanical circulatory support. Logistic regression was used to identify variables associated with PPCM.
  
  
  RESULTS
  In total, 535 of 4,003,914 records of delivering mothers specified a diagnosis of PPCM. Prevalence of PPCM was highest among African Americans and similar in Caucasians and Hispanics. Established risk factors including age 30 years, African- American race, hypertension, preeclampsia/eclampsia, and multigestational status were associated with PPCM, and novel associations such as anemia and asthma were identified. Autoimmune disease and substance abuse, which can cause cardiomyopathy independently, were also associated with PPCM. Maternal MAE (odds ratio: 436, p < 0.0001) and stillbirth (odds ratio: 3.8, p < 0.0001) occurred more frequently among women with PPCM.
  
  
  CONCLUSIONS
  The prevalence of PPCM at the time of delivery in Hispanics was similar to Caucasians and lower than African Americans. Autoimmune disease, substance abuse, anemia and asthma were conditions associated with PPCM not consistently identified in smaller cohorts. Peripartum cardiomyopathy was also associated with increased risk of stillbirth and maternal MAEs at delivery.
authors.forename: David P
authors.initials: DP
authors.lastname: Kao
authors.forename: Eileen
authors.initials: E
authors.lastname: Hsich
authors.forename: JoAnn
authors.initials: J
authors.lastname: Lindenfeld
mesh_terms: D000293:Adolescent; D000328:Adult; D001741:Black or African American; D009202:Cardiomyopathies / Q000175:diagnosis* / Q000453:epidemiology*; D005260:Female; D006630:Hispanic or Latino; D006801:Humans; D011247:Pregnancy; D011249:Pregnancy Complications, Cardiovascular / Q000175:diagnosis* / Q000453:epidemiology*; D011256:Pregnancy Outcome; D012189:Retrospective Studies; D044465:White People; D055815:Young Adult