Abstract 4114436: Feto-maternal outcomes of subsequent pregnancy among women with Peripartum Cardiomyopathy in Tanzania.

Background: Besides survival and recovery, women afflicted with peripartum cardiomyopathy (PPCM) harbor significant apprehension regarding the safety of future pregnancies. Current knowledge regarding the maternal and fetal outcomes in subsequent pregnancies among women with a history of PPCM is sparse. Likewise, there is insufficient medical evidence to provide guidance for women who opt to become pregnant again after experiencing PPCM. Research Questions: What is the feto-maternal prognosis of subsequent pregnancies following a history of PPCM? Aims: To describe the fetal and maternal outcomes of subsequent pregnancies following a history of PPCM. Methods: We included women from the Tanzania PPCM registry who had subsequent pregnancies after PPCM and assessed PPCM recurrence, maternal prognosis, and fetal outcomes. Results: Among the 870 survivors (286 of whom left ventricular function had returned to normal [group 1] and 584 with persistent left ventricular dysfunction [group 2]), subsequent pregnancies were observed in 121 (13.9%) women (78 in group 1 and 43 in group 2). Forty (51.3%) women in group 1 had PPCM relapse, and during a mean follow-up of 896 days, 34 (85.0%) had complete recovery, 3 (7.5%) had persistent heart failure, and 3 (7.5%) died. In group 2, four (9.3%) women had complete recovery, 32 (74.4%) had persistent heart failure, and 7 (16.3%) died. The infant mortality rate was 23.4%. Conclusions: After the initial pregnancy complicated by peripartum cardiomyopathy, subsequent pregnancies could lead to PPCM relapse and deleterious feto-maternal outcomes, including death.