A 20-Year Population Study of Peripartum Cardiomyopathy

Quick Takes

  • Risk factors for peripartum cardiomyopathy include obesity, gestational hypertensive disorders, and multiple gestation pregnancies.
  • Long-term outcomes for patients with peripartum cardiomyopathy in Scotland included a mortality rate of 8% and recovery of 76%.

Study Questions:

What are the epidemiology patterns and long-term outcomes of peripartum cardiomyopathy (PPCM) in Europe?


This was a retrospective, observational, population-level study of patients hospitalized with presumed PPCM in Scotland from 1998–2017. Each case was matched to 10 age-matched controls. Incidence, risk factors, morbidity, and mortality were examined.


In Scotland, the incidence of PPCM was 1 in 4,950 deliveries, with higher risks in patients with obesity, gestational hypertensive disorders, and multiple gestation pregnancies. There was a median follow-up of 8.3 years, mortality was 8%, rehospitalization was 75%, and composite outcome (all-cause death, mechanical circulatory support, or cardiac transplantation) was 14%. Recovery of myocardial function occurred in 76%; of these, 13% had subsequent decline in systolic cardiac function. Children born to women with PPCM had 5 times higher mortality than those born to controls.


PPCM occurred in 1 in 4,950 deliveries and was associated with morbidity and mortality for both mother and baby.


This study highlights the significant morbidity and mortality related to PPCM. The data analyzed were from the National Health Service, which covers nearly all health care in Scotland, providing a rich source of information about the incidence and natural history of PPCM. Previously recognized risk factors included gestational hypertensive disorders, obesity, and multiple gestational pregnancies. The recovery rate was 76%; however, 13% had subsequent decline in function, highlighting the importance of long-term follow-up for patients, even after presumed recovery. The increased risk of infant morbidity and mortality was also significant. Ongoing long-term follow-up after PPCM is essential.

Clinical Topics: Heart Failure and Cardiomyopathies

Keywords: Cardiomyopathies, Infant Mortality, Peripartum Period

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