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Multicenter Study
. 2020 Feb;7(1):235-243.
doi: 10.1002/ehf2.12562. Epub 2020 Jan 28.

Incidence, clinical characteristics, and risk factors of peripartum cardiomyopathy in Nigeria: results from the PEACE Registry

K M Karaye  1   2   3 , N A Ishaq  2 , H Sa'idu  1 , S A Balarabe  4 , M A Talle  5 , M S Isa  6 , U G Adamu  7 , H Umar  8 , H I Okolie  9 , M N Shehu  10   11 , I Y Mohammed  12   13 , B Sanni  2 , O S Ogah  14 , I Oboirien  15 , E M Umuerri  16 , A C Mankwe  17 , V Y Shidali  18 , P Njoku  19 , S Dodiyi-Manuel  20 , T T Shogade  21 , T Olunuga  22 , D Ojji  23 , V Josephs  22 , A C Mbakwem  24 , J Tukur  25   26 , S A Isezuo  8 ; PEACE Registry Investigators
Affiliations
Multicenter Study

Incidence, clinical characteristics, and risk factors of peripartum cardiomyopathy in Nigeria: results from the PEACE Registry

K M Karaye et al. ESC Heart Fail. 2020 Feb.

Abstract

Aims: The aim of this study was to describe the incidence, clinical characteristics and risk factors of peripartum cardiomyopathy (PPCM) in Nigeria.

Methods and results: The study was conducted in 22 hospitals in Nigeria, and PPCM patients were consecutively recruited between June 2017 and March 2018. To determine factors associated with PPCM, the patients were compared with apparently healthy women who recently delivered, as controls. Four hundred six patients were compared with 99 controls. The incidence and disease burden (based on the rate of consecutive recruitment of subjects) varied widely between the six geographical zones of Nigeria. From the North-West zone, 72.3% of the patients was recruited, where an incidence as high as 1 per 96 live births was obtained in a centre, while the disease was uncommon (7.6% of all recruited patients) in the South. Majority of the patients (76.6%) and controls (74.8%) (p = 0.694) were of Hausa-Fulani ethnic group. Atrial fibrillation, intracardiac thrombus, stroke, and right ventricular systolic dysfunction were found in 1.7%, 6.4%, 2.2%, and 54.9% of the patients, respectively. Lack of formal education (odds ratio [OR] 3.08, 95% confidence interval [1.71, 5.53]; P < 0.001), unemployment (OR: 3.28 [2.05, 5.24]; P < 0.001), underweight (OR: 13.43 [4.17, 43.21]; P < 0.001) and history of pre-eclampsia (OR: 9.01 [2.18, 37.75]; P = 0.002) emerged as independent PPCM risk factors using regression models. Customary hot baths (OR: 1.24 [0.80, 1.93]; P = 0.344), pap enriched with dried lake salt (OR: 1.20 [0.74, 1.94]; P = 0.451), and Hausa-Fulani ethnicity (OR: 1.11 [0.67, 1.84]; P = 0.698) did not achieve significance as PPCM risk factors.

Conclusions: In Nigeria, the burden of PPCM was greatest in the North-West zone, which has the highest known incidence. PPCM was predicted by sociodemographic factors and pre-eclampsia, which should be considered in its control at population level. Postpartum customary birth practices and Hausa-Fulani ethnicity were not associated with PPCM in Nigeria.

Keywords: Incidence; PEACE Registry; Peripartum cardiomyopathy; Risk factors.

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Conflict of interest statement

None declared.

Figures

Figure 1
Figure 1
Map of Nigeria displaying the distribution of Peripartum Cardiomyopathy in Nigeria Registry study sites. Legend: Map of Nigeria with the red flags and green stars indicating the sites that recruited peripartum cardiomyopathy patients and controls respectively, in the various geopolitical zones and states.
Figure 2
Figure 2
Map of Nigeria displaying the incidence rate of peripartum cardiomyopathy by states. Legend: Map of Nigeria displaying the incidence of peripartum cardiomyopathy by states in five geographic zones.
See this image and copyright information in PMC

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