Mortality and clinical outcomes in peripartum cardiomyopathy: A systematic review and meta-analysis.

BACKGROUND

Peripartum cardiomyopathy (PPCM) is an important cause of maternal cardiovascular morbidity and mortality, characterized by the development of left ventricular systolic dysfunction toward the end of pregnancy or in the months following delivery. We aimed to evaluate all-cause mortality and clinical outcomes in women with PPCM.

METHODS

We performed a systematic review and meta-analysis of studies evaluating outcomes in PPCM. PubMed, Embase, and Web of Science were searched from inception through April 2026. Studies reporting all-cause mortality and/or heart failure hospitalization were included. Pooled event rates were estimated using a random-effects model with logit transformation.

RESULTS

A total of 60 studies comprising 44,922 patients were included. The pooled all-cause mortality rate was 7% (95% confidence interval [CI] 5-9%), with substantial heterogeneity (I2 = 96.4%). Reported mortality ranged from 0% to over 25%, reflecting marked variability across geographic regions and clinical settings. Heart failure hospitalization was reported in three studies; the pooled rate was 11% (95% CI 1-63%), although this estimate should be interpreted cautiously given the limited evidence base and substantial heterogeneity.

CONCLUSIONS

Peripartum cardiomyopathy is associated with a meaningful risk of mortality, with substantial variability across populations. These findings highlight the need for improved recognition, risk stratification, and standardized longitudinal cardiovascular care in women with PPCM.