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. 2018 Jun 18;18(1):119.
doi: 10.1186/s12872-018-0856-7.

Maternal and fetal prognosis of subsequent pregnancy in black African women with peripartum cardiomyopathy

Nobila Valentin Yaméogo  1 , André Koudnoaga Samadoulougou  1 , Larissa Justine Kagambèga  2 , Koudougou Jonas Kologo  1 , Georges Rosario Christian Millogo  1 , Anna Thiam  1 , Charles Guenancia  3   4 , Patrice Zansonré  1
Affiliations

Maternal and fetal prognosis of subsequent pregnancy in black African women with peripartum cardiomyopathy

Nobila Valentin Yaméogo et al. BMC Cardiovasc Disord. .

Abstract

Background: The aim of this study was to describe maternal and fetal outcomes after pregnancy complicated by peripartum cardiomyopathy (PPCM).

Methods: We included women that had subsequent pregnancy (SSP) after PPCM and assessed maternal prognosis and pregnancy outcomes, in-hospital up to one week after discharge. Clinical and echocardiographic data were collected comparing alive and deceased women. Factors associated with pregnancy outcomes were assessed.

Results: Twenty-nine patients were included, with a mean age of 26.7 ± 4.6 years and a mean gravidity number of 2.3 ± 0.5 of. At the last medical control before subsequent pregnancy, there was no congestive heart failure, the mean left ventricular diastolic diameter (LVDD) was 53 ± 4 mm and the left ventricular ejection fraction (LVEF) was ≥50% in 13 cases (44.8%). Maternal outcomes were marked by 14 deaths (48.3%). Among the factors tested in univariate analysis, LVEF at admission had an excellent receiver-operating characteristic (ROC) curve to predict maternal mortality (AUC = 0.95; 95% CI 0.87-1, p < 0.001), with a cut off value of < 40% (sensitivity = 93% and specificity = 87%). Concerning fetal outcomes, baseline LVEF had the best area under the curve (AUC) to predict abortion or prematurity among all variables (AUC = 0.75; 95% CI 0.58-092, p = 0.003), with a cut-off value of < 50% (sensitivity = 79%, specificity = 67%).

Conclusions: SSP outcomes are still severe in our practice. Maternal mortality remains high and is linked to ventricular systolic function at admission (due to pregnancy), while fetal outcomes are linked to baseline LVEF before pregnancy.

Keywords: Burkina Faso; Peripartum cardiomyopathy; Prognosis; Subsequent pregnancy.

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Conflict of interest statement

Ethics approval and consent to participate

We received the approval of the medical ethics committee (comité d’éthique pour la santé au Burkina Faso) and each patient signed an informed consent or affixed their digital loan to participate in the study. Patients applied the fingerprints of his index finger, after having traced it in blue ink.

Consent for publication

Not Applicable.

Competing interests

The authors declares that they have no competing interest.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Figures

Fig. 1
Fig. 1
ROC curves with optimal cut-off values of LVEF (admission, baseline and delta) to predict mortality
Fig. 2
Fig. 2
ROC curves of TAPSE (admission, baseline and delta) to predict mortality
Fig. 3
Fig. 3
ROC curves of sPAP (admission, baseline and delta) to predict mortality
See this image and copyright information in PMC

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