Racial Differences in Delivery Outcomes Among Women With Peripartum Cardiomyopathy

Peripartum cardiomyopathy (PPCM) is a rare idiopathic cardiomyopathy associated with pregnancy that occurs more frequently among Black women. However, less is known about the association of race/ethnicity with outcomes at the time of delivery in women with PPCM.

We used data from the 2016-2018 National Inpatient Sample (NIS) database to identify women with a diagnosis of PPCM based on International Classification of Diseases, 10th revision (ICD-10) codes. Using adjusted logistic regression, the association of race with PPCM and adverse cardiovascular (CV) outcomes with PPCM was evaluated across racial/ethnic groups (White, Black, Hispanic, Asian/Pacific Islander).

Among 11,304,996 delivery hospitalizations, PPCM was present in 8735 (0.08%). After adjusting for CV risk factors (chronic hypertension, diabetes, and obesity) and socioeconomic factors (insurance status, hospital income, and residential income), Black and Native American women had greater adjusted odds of developing PPCM (adjusted odds ratio [aOR] 1.89; 95% confidence interval [CI] 1.66-2.15; aOR 1.60; 95% CI 1.02-2.50, respectively), compared with White women. In stratified analysis of CV events, however, Asian/Pacific Islander women with PPCM were the most likely to have CV complications (aOR 98; 95% CI 29-333 for pulmonary edema).

In the US, at the time of delivery hospitalization, Black and Native American women are the most likely to develop PPCM, despite adjustment for CV and socioeconomic risk factors, but Asian women have higher odds of having CV complications.