Peripartum heart failure in Finland: A population-based record linkage study

Area of Science:

• Cardiology
• Obstetrics & Gynecology
• Public Health

Background:

• Heart failure in late pregnancy and the postpartum period (HFPP), a rare but serious condition, most commonly presents as peripartum cardiomyopathy (PPCM).
• Understanding the prevalence and risk factors of HFPP in specific populations is crucial for developing effective prevention and management strategies.

Purpose of the Study:

• To determine the incidence of HFPP in the Finnish population between 1996 and 2021.
• To identify maternal risk factors associated with the occurrence of HFPP.

Main Methods:

• A retrospective analysis of 1,387,457 deliveries using Finnish national health registers (1996-2021).
• HFPP cases were identified using ICD-10 codes, with exclusions for pre-existing cardiac conditions.
• Logistic regression models were used to assess the association between maternal factors and HFPP incidence.

Main Results:

• An overall incidence of 11.5 HFPP cases per 100,000 deliveries was observed.
• Significant risk factors identified include maternal obesity (BMI ≥35), history of hypertensive disorders, gestational hypertension, preeclampsia, type 1 or 2 diabetes, and twin pregnancies.
• Increased prepartum/postpartum blood loss and maternal mental health disorders were also strongly associated with HFPP.

Conclusions:

• The incidence of HFPP in Finland is low but associated with several significant risk factors.
• Preeclampsia, obesity, diabetes, multiple gestations, and mental health disorders are key risk factors requiring attention.
• Targeted interventions and monitoring for high-risk pregnancies are essential to reduce the impact of HFPP.