Peripartum Cardiomyopathy Among Women with Prepregnancy Obesity

Researchers reviewed the association between pre-pregnancy obesity and incidence of peripartum cardiomyopathy.

People with prepregnancy obesity face greater risk of peripartum cardiomyopathy (PPCM) than people who are not obese, according to study results published recently in the Indian Heart Journal.

Researchers conducted a systematic search of multiple databases that led to data from 5,373,581 participants being gathered from 5 observational studies. The focus of investigation was on observational studies of prepregnancy obesity and peripartum cardiomyopathy, with obesity defined as per World Health Organization (WHO) standards and PPCM defined as per guidelines of the European Society of Cardiology. Of the over 5 million participants, 506 had PPCM.

Meta-analysis disclosed a significant association between prepregnancy obesity and PPCM compared with women who were not obese (OR = 1.79 [1.16-2.76]; P =.008; I2 = 59%; Pheterogeneity =.04). Excluding the 1 study that did not find an association between prepregnancy obesity and PPCM, sensitivity analysis showed heterogeneity decreased to 9% with a higher odds ratio maintaining significance (OR = 2.04 [1.61-2.60]; P <.001; I2 = 9%; Pheterogeneity =.35).

Among prepregnancy women with obesity class I, subgroup analysis showed (OR = 1.58 [1.20-2.07]; P =.001; I2 = 0%; Pheterogeneity =.64) a significant association with PPCM, also seen between prepregnancy women with obesity class II and III and PPCM (OR = 2.65 [2.04-3.45]; P <.001; I2 = 6%; Pheterogeneity =.36).

Study limitations included analysis of only a small number of retrospective observational studies with moderate or greater heterogeneity of race and ethnicity.

“…this study suggested that patients with prepregnancy obesity are at higher risk of developing PPCM,” the study authors noted. “To truly evaluate the impact of obesity on PPCM, prospective observational studies with heterogenous population are needed.”


Putra ICS, Irianto CB, Raffaello WM, Suciadi LP, Prameswari HS. Pre-pregnancy obesity and the risk of peripartum cardiomyopathy: A systematic review and meta-analysis. Indian Heart J. Published online April 28, 2022. doi:10.1016/j.ihj.2022.04.009