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Heart Failure in Late Pregnancy and Postpartum: Incidence and Long-Term Mortality in Sweden From 1997 to 2010

Artikel i vetenskaplig tidskrift
Författare Anders Barasa
Annika Rosengren
Tatiana Zverkova Sandström
Lars Ladfors
Maria Schaufelberger
Publicerad i Journal of Cardiac Failure
Volym 23
Nummer/häfte 5
Sidor 370-378
ISSN 1071-9164
Publiceringsår 2017
Publicerad vid Institutionen för medicin, avdelningen för molekylär och klinisk medicin
Institutionen för kliniska vetenskaper, Avdelningen för obstetrik och gynekologi
Sidor 370-378
Språk en
Länkar https://doi.org/10.1016/j.cardfail....
Ämnesord Cardiomyopathy, epidemiology, heart failure, pregnancy, postpartum, peripartum cardiomyopathy, racial-differences, outcomes, preeclampsia, predictors, management, diagnosis, prognosis, statement, Cardiovascular System & Cardiology
Ämneskategorier Epidemiologi, Kardiovaskulär medicin

Sammanfattning

Background: Heart failure (HF) in late pregnancy and postpartum (HFPP), of which peripartum cardiomyopathy (PPCM) constitutes the larger part, is still a rare occurrence in Sweden. Population-based data are scarce. Our aim was to characterize HFPP and determine the incidence and mortality in a Swedish cohort. Methods and Results: Through merging data from the National Inpatient, Cause of Death, and Medical Birth Registries, we identified ICD-10 codes for HF and cardiomyopathy within 3 months before delivery to 6 months postpartum. Each case was assigned 5 age -matched control subjects from the Medical Birth Registry. From 1997 to 2010, 241 unique HFPP case subjects and 1063 matched control subjects were identified. Mean incidence was 1 in 5719 deliveries. HFPP was strongly associated with preeclampsia (odds ratio [OR] 11.91, 95% confidence interval [CI] 7.86-18.06), obesity (OR 2.5, 95% CI 1.7-3.7), low-and middle -income country (LMIC) of origin (OR 1.73, 95% CI 1.14-2.63), and twin deliveries (OR 4.39 CI 95% 2.24-8.58). By the end of the study period deaths among cases were > 35 -fold those of controls: 9 cases (3.7 %) and 1 control (0.1 %; P <.0001). Among control subjects, 17.9% of mortalities occurred within 3 years, of diagnosis compared with 100% among cases. Conclusions: The mean incidence and mortality among women with HFPP in Sweden from 1997 to 2010 was low but carried a marked excess risk of death compared with control subjects and was strongly linked to preeclampsia, obesity, multifetal births, and LMIC origin of the mother. (J Cardiac Fail 2017;23:370-378)

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