Outcomes for Pregnant Women With Cardiomyopathy Assessed
Pregnant women with dilated cardiomyopathy found to have more cardiac, neonatal incidents
MONDAY, Jan. 4 (HealthDay News) -- Women with dilated cardiomyopathy (DCM) who become pregnant are at elevated risk for a having a cardiac event as well as adverse neonatal events, according to a study in the Dec. 29/Jan. 5 issue of the Journal of the American College of Cardiology.
Jasmine Grewal, M.D., of the University of Toronto, and colleagues followed 32 women (36 pregnancies) with DCM presenting between 1994 and 2008. Multivariate analysis was used to identify predictors of cardiac complications during pregnancy for women with DCM, and their cardiac outcomes were compared to non-pregnant women with DCM.
In follow-up, the researchers found that 39 percent (14 of 36) of the pregnancies were complicated by one or more cardiac incidents for the mother. Moderate or severe left ventricular (LV) dysfunction and/or New York Heart Association functional class III or IV were predictors of adverse maternal cardiac outcomes. Among women with moderate/severe LV dysfunction, 16-month event-free survival was worse in pregnant women with DCM than in the non-pregnant women (28 versus 83 percent). Adverse neonatal event rates were highest for women who had both obstetric and cardiac risk factors: 43 percent for moderate-to-severe LV dysfunction and 20 percent for mild LV dysfunction.
"In pregnant women with DCM, the risk of adverse cardiac events is considerable, and pre-pregnancy characteristics can identify women at the highest risk. Pregnancy seems to have a short-term negative impact on the clinical course in women with DCM," the authors write.