Socio-economic factors determine maternal and neonatal outcomes in women with peripartum cardiomyopathy: A study of the ESC EORP PPCM registry.

Ethnicity Gini index HDI HE Peripartum cardiomyopathy Socio-economic factors

Journal

International journal of cardiology
ISSN: 1874-1754
Titre abrégé: Int J Cardiol
Pays: Netherlands
ID NLM: 8200291

Informations de publication

Date de publication:
17 Nov 2023
Historique:
received: 19 05 2023
revised: 20 09 2023
accepted: 14 11 2023
pubmed: 19 11 2023
medline: 19 11 2023
entrez: 18 11 2023
Statut: aheadofprint

Résumé

Peripartum cardiomyopathy (PPCM) is a global disease with substantial morbidity and mortality. The aim of this study was to analyze to what extent socioeconomic factors were associated with maternal and neonatal outcomes. In 2011, >100 national and affiliated member cardiac societies of the European Society of Cardiology (ESC) were contacted to contribute to a global PPCM registry, under the auspices of the ESC EORP Programme. We investigated the characteristics and outcomes of women with PPCM and their babies according to individual and country-level sociodemographic factors (Gini index coefficient [GINI index], health expenditure [HE] and human developmental index [HDI]). 739 women from 49 countries (Europe [33%], Africa [29%], Asia-Pacific [15%], Middle East [22%]) were enrolled. Low HDI was associated with greater left ventricular (LV) dilatation at time of diagnosis. However, baseline LV ejection fraction did not differ according to sociodemographic factors. Countries with low HE prescribed guideline-directed heart failure therapy less frequently. Six-month mortality was higher in countries with low HE; and LV non-recovery in those with low HDI, low HE and lower levels of education. Maternal outcome (death, re-hospitalization, or persistent LV dysfunction) was independently associated with income. Neonatal death was significantly more common in countries with low HE and low HDI, but was not influenced by maternal income or education attainment. Maternal and neonatal outcomes depend on country-specific socioeconomic characteristics. Attempts should therefore be made to allocate adequate resources to health and education, to improve maternal and fetal outcomes in PPCM.

Sections du résumé

BACKGROUND BACKGROUND
Peripartum cardiomyopathy (PPCM) is a global disease with substantial morbidity and mortality. The aim of this study was to analyze to what extent socioeconomic factors were associated with maternal and neonatal outcomes.
METHODS METHODS
In 2011, >100 national and affiliated member cardiac societies of the European Society of Cardiology (ESC) were contacted to contribute to a global PPCM registry, under the auspices of the ESC EORP Programme. We investigated the characteristics and outcomes of women with PPCM and their babies according to individual and country-level sociodemographic factors (Gini index coefficient [GINI index], health expenditure [HE] and human developmental index [HDI]).
RESULTS RESULTS
739 women from 49 countries (Europe [33%], Africa [29%], Asia-Pacific [15%], Middle East [22%]) were enrolled. Low HDI was associated with greater left ventricular (LV) dilatation at time of diagnosis. However, baseline LV ejection fraction did not differ according to sociodemographic factors. Countries with low HE prescribed guideline-directed heart failure therapy less frequently. Six-month mortality was higher in countries with low HE; and LV non-recovery in those with low HDI, low HE and lower levels of education. Maternal outcome (death, re-hospitalization, or persistent LV dysfunction) was independently associated with income. Neonatal death was significantly more common in countries with low HE and low HDI, but was not influenced by maternal income or education attainment.
CONCLUSIONS CONCLUSIONS
Maternal and neonatal outcomes depend on country-specific socioeconomic characteristics. Attempts should therefore be made to allocate adequate resources to health and education, to improve maternal and fetal outcomes in PPCM.

Identifiants

pubmed: 37979788
pii: S0167-5273(23)01686-8
doi: 10.1016/j.ijcard.2023.131596
pii:
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

131596

Informations de copyright

Copyright © 2023. Published by Elsevier B.V.

Déclaration de conflit d'intérêts

Declaration of Competing Interest None of the authors have any conflict of interest to declare related to this manuscript.

Auteurs

Karen Sliwa (K)

Cape Heart Institute, Department of Medicine and Cardiology, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa; Division of Cardiology, Department of Medicine, Groote Schuur Hospital, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa. Electronic address: Karen.Sliwa-Hahnle@uct.ac.za.

Peter van der Meer (P)

Department of Cardiology, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands.

Charle Viljoen (C)

Cape Heart Institute, Department of Medicine and Cardiology, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa; Division of Cardiology, Department of Medicine, Groote Schuur Hospital, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa.

Alice M Jackson (AM)

Institute of Cardiovascular and Medical Sciences, Glasgow University, Glasgow, United Kingdom.

Mark C Petrie (MC)

Institute of Cardiovascular and Medical Sciences, Glasgow University, Glasgow, United Kingdom.

Alexandre Mebazaa (A)

Department of Anaesthesia and Critical Care, University Hospitals Saint Louis-Lariboisière Paris, University Paris Diderot, Paris, France.

Denise Hilfiker-Kleiner (D)

Faculty of Medicine, Philipps-University Marburg, Marburg, Germany.

Aldo P Maggioni (AP)

ANMCO Research Centre, Firenze, Italy; EURObservational Research Programme, European Society of Cardiology, Sophia Antipolis, France.

Cecile Laroche (C)

EURObservational Research Programme, European Society of Cardiology, Sophia Antipolis, France.

Vera Regitz-Zagrosek (V)

Berlin Institute of Gender in Medicine (GiM), Charité - Universitätsmedizin, Berlin, Germany.

Luigi Tavazzi (L)

Maria Cecilia Hospital, GVM Care & Research, Cotignola, Italy.

Jolien W Roos-Hesselink (JW)

Department Cardiology, Thoraxcenter, Erasmus Medical Center, Rotterdam, the Netherlands.

Righab Hamdan (R)

Cardiology Department, Al Qassimi Hospital, Sharjah, United Arab Emirates.

Alexandra Frogoudaki (A)

Atticon University Hospital, Chaidari, Greece.

Bassem Ibrahim (B)

North Cumbria University Hospitals, Carlisle, UK.

Hasan Ali Farhan Farhan (HAF)

Iraqi Board for Medical Specializations, Scientific Council of Cardiology, College of Medicine, University of Baghdad, Baghdad Heart Center, Baghdad, Iraq.

Amam Mbakwem (A)

Department of Medicine, College of Medicine and Lagos University Teaching Hospital, Lagos, Nigeria.

Petar Seferovic (P)

University of Belgrade Faculty of Medicine, Belgrade, Serbia.

Michael Böhm (M)

Klinik für Innere Medizin III, Kardiologie, Angiologie und Internistische Intensivmedizin, Universitätsklinikum des Saarlandes, Homburg, Germany.

Burkert Pieske (B)

Department of Cardiology, Charité-Universitätsmedizin, Berlin, Germany.

Mark R Johnson (MR)

Department of Obstetrics, Imperial College School of Medicine, Chelsea and Westminster Hospital, London, United Kingdom.

Johann Bauersachs (J)

Department of Cardiology and Angiology, Medical School Hannover, Hannover, Germany.

Classifications MeSH