Pregnancy and Cardiomyopathy: A Prospective Cohort Study

Abstract

Objective To establish in a national cohort whether the type of cardiomyopathy in women with a prepregnancy diagnosis affected pregnancy outcomes including mortality, gestational age at birth, and delivery type. Design Prospective Observational study using United Kingdom Obstetric Surveillance System (UKOSS). Population Women with pre‐pregnancy diagnosis of cardiomyopathy. Methods Cases included were defined as women with pre‐pregnancy diagnosis of cardiomyopathy (dilated cardiomyopathy, hypertrophic cardiomyopathy, arrhymogenic right ventricular cardiomyopathy, or Peripartum Cardiomyopathy (PPCM)). Details were notified monthly to UKOSS (1st June 2021 until the 31st May 2024). Main Outcome Measures Obstetric, neonatal, and cardiovascular outcomes. Results 210 pregnancies in 209 women were identified, 103/209 (49.3%) with dilated cardiomyopathy, 40/209 (19.1%) with hypertrophic cardiomyopathy, 24/209 (11.5%) with previous PPCM, 11/209 (5.3%) with arrhythmogenic right ventricular cardiomyopathy and 31/209 (14.8%) women with ‘other’ cardiomyopathies. Median gestation at delivery in 206 singleton pregnancies was 38.1 (IQR 259–273) weeks; 36/180 (20%) of babies with data recorded were admitted to the neonatal unit. There were no maternal deaths. 10% of women had a documented episode of heart failure and 8% a documented arrhythmia during pregnancy. Conclusions Pregnancies in women with cardiomyopathy managed in the UK typically have successful outcomes, consistent with published data. Maternal cardiac complications rate was small. There were no maternal deaths.