ORIGINAL ARTICLEFive-Year Prospective Study of the Incidence and Prognosis of Peripartum Cardiomyopathy at a Single Institution
Section snippets
PATIENTS AND METHODS
All patients included in this study were identified through a search of the HAS PPCM Registry of patients who presented for treatment February 1, 2000, through January 31, 2005. The PPCM Project used the definition of PPCM outlined by Demakis and Rahimtoola,5 namely, the unexplained appearance of heart failure (HF) in a previously healthy patient during the last month of pregnancy or up to 5 months postpartum (similar to the National Institutes of Health consensus definition published
RESULTS
A total of 98 patients with PPCM were identified through the HAS PPCM Registry and were included in this study. Of these 98 patients, 92 were observed for at least 6 months.
DISCUSSION
Haiti has desperate poverty and limited medical resources. We report the natural history of PPCM in a large cohort of HIV-negative mothers from a defined catchment population in Haiti. Of the PPCM patients, 24 (24%) of 98 were primiparas. The longer observation period of 5 years has confirmed that multiparity and increased age are not as important risk factors as initially thought for this population.1, 2 The development of PPCM with the first pregnancy may hold important clues concerning the
CONCLUSION
Peripartum cardiomyopathy occurs appreciably more often in rural Haiti on a per capita basis than in the United States. In addition, patients with PPCM have high mortality rates and poor rates of return of normal left ventricular function. The reasons for these findings are unknown, although we have identified particular areas of interest for subsequent investigation.13, 14, 15, 16
Acknowledgments
The HAS PPCM Project gratefully acknowledges the assistance of Maryetta King, MD, Associate Professor of Pediatrics, Harvard Medical School, and Director of Pediatric Echocardiography at Massachusetts General Hospital, for her contribution as a medical volunteer in providing echocardiographic expertise in the early phase of this study.
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Funding from volunteer medical consultants and private contributions to humanitarian program of Hôpital Albert Schweitzer, Deschapelles, Haiti.