Incidence, Risk Factors, and Clinical Characteristics of Peripartum Cardiomyopathy in South Korea

Sunki Lee, Geum-Joon Cho, Geun U. Park, Log Young Kim, Tae Seon Lee, Do Young Kim, Suk Won Choi, Jong Chan Youn, Seong Woo Han, Kyu Hyung Ryu, Jin Oh Na, Cheol Ung Choi, Hong Seog Seo, Eung Ju Kim

Research output: Contribution to journalArticle

7 Citations (Scopus)

Abstract

Background: Peripartum cardiomyopathy (PPCM) is a rare disorder associated with pregnancy that can lead to life-threatening conditions. The incidence and clinical characteristics of this condition remain poorly understood. Methods and Results: We aimed to perform the first population-based study of PPCM in South Korea, using the Korea National Health Insurance Claims Database of the Health Insurance Review and Assessment Service. Patients who fulfilled predefined diagnostic criteria for PPCM from January 1, 2010, to December 31, 2012, were identified from International Classification of Diseases, Tenth Revision, Clinical Modification codes. To discriminate PPCM from other causes of heart failure, we excluded subjects who already had heart failure-related International Classification of Diseases, Tenth Revision, Clinical Modification codes at least 1 year before delivery. During the study period, there were 1 404 551 deliveries in South Korea, and we excluded 20 159 patients who already had heart failure. In those, a total of 795 cases were identified as PPCM. Patients with PPCM were older, had a higher prevalence of preeclampsia and gestational diabetes mellitus, and were more likely to be primiparous and have multiple pregnancies. Moreover, cesarean section and pregnancy-related complications and in-hospital death were also more common in patients with PPCM. Intriguingly, a considerable number of heart failure cases (n=64; 8.1% of total PPCM) were noted between 5 and 12 months after delivery. Conclusions: The incidence of PPCM was 1 in 1741 deliveries in South Korea. Patients with PPCM were older, were more associated with primiparity and multiple pregnancy, had more pregnancy-related complications, and revealed higher in-hospital mortality than controls. The number of cases diagnosed as PPCM were decreased over time after delivery; however, a large number of patients were still noted through 12 months after delivery.

Original languageEnglish
Article numbere004134
JournalCirculation: Heart Failure
Volume11
Issue number4
DOIs
Publication statusPublished - 2018 Apr 1

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Peripartum Period
Republic of Korea
Cardiomyopathies
Incidence
Heart Failure
Multiple Pregnancy
Pregnancy Complications
International Classification of Diseases
Gestational Diabetes
National Health Programs
Health Insurance
Korea
Hospital Mortality
Pre-Eclampsia
Parity
Cesarean Section

Keywords

  • cardiomyopathies
  • heart failure
  • peripartum period
  • pregnancy
  • risk factors

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Incidence, Risk Factors, and Clinical Characteristics of Peripartum Cardiomyopathy in South Korea. / Lee, Sunki; Cho, Geum-Joon; Park, Geun U.; Kim, Log Young; Lee, Tae Seon; Kim, Do Young; Choi, Suk Won; Youn, Jong Chan; Han, Seong Woo; Ryu, Kyu Hyung; Na, Jin Oh; Choi, Cheol Ung; Seo, Hong Seog; Kim, Eung Ju.

In: Circulation: Heart Failure, Vol. 11, No. 4, e004134, 01.04.2018.

Research output: Contribution to journalArticle

Lee, Sunki ; Cho, Geum-Joon ; Park, Geun U. ; Kim, Log Young ; Lee, Tae Seon ; Kim, Do Young ; Choi, Suk Won ; Youn, Jong Chan ; Han, Seong Woo ; Ryu, Kyu Hyung ; Na, Jin Oh ; Choi, Cheol Ung ; Seo, Hong Seog ; Kim, Eung Ju. / Incidence, Risk Factors, and Clinical Characteristics of Peripartum Cardiomyopathy in South Korea. In: Circulation: Heart Failure. 2018 ; Vol. 11, No. 4.
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abstract = "Background: Peripartum cardiomyopathy (PPCM) is a rare disorder associated with pregnancy that can lead to life-threatening conditions. The incidence and clinical characteristics of this condition remain poorly understood. Methods and Results: We aimed to perform the first population-based study of PPCM in South Korea, using the Korea National Health Insurance Claims Database of the Health Insurance Review and Assessment Service. Patients who fulfilled predefined diagnostic criteria for PPCM from January 1, 2010, to December 31, 2012, were identified from International Classification of Diseases, Tenth Revision, Clinical Modification codes. To discriminate PPCM from other causes of heart failure, we excluded subjects who already had heart failure-related International Classification of Diseases, Tenth Revision, Clinical Modification codes at least 1 year before delivery. During the study period, there were 1 404 551 deliveries in South Korea, and we excluded 20 159 patients who already had heart failure. In those, a total of 795 cases were identified as PPCM. Patients with PPCM were older, had a higher prevalence of preeclampsia and gestational diabetes mellitus, and were more likely to be primiparous and have multiple pregnancies. Moreover, cesarean section and pregnancy-related complications and in-hospital death were also more common in patients with PPCM. Intriguingly, a considerable number of heart failure cases (n=64; 8.1{\%} of total PPCM) were noted between 5 and 12 months after delivery. Conclusions: The incidence of PPCM was 1 in 1741 deliveries in South Korea. Patients with PPCM were older, were more associated with primiparity and multiple pregnancy, had more pregnancy-related complications, and revealed higher in-hospital mortality than controls. The number of cases diagnosed as PPCM were decreased over time after delivery; however, a large number of patients were still noted through 12 months after delivery.",
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AU - Lee, Sunki

AU - Cho, Geum-Joon

AU - Park, Geun U.

AU - Kim, Log Young

AU - Lee, Tae Seon

AU - Kim, Do Young

AU - Choi, Suk Won

AU - Youn, Jong Chan

AU - Han, Seong Woo

AU - Ryu, Kyu Hyung

AU - Na, Jin Oh

AU - Choi, Cheol Ung

AU - Seo, Hong Seog

AU - Kim, Eung Ju

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N2 - Background: Peripartum cardiomyopathy (PPCM) is a rare disorder associated with pregnancy that can lead to life-threatening conditions. The incidence and clinical characteristics of this condition remain poorly understood. Methods and Results: We aimed to perform the first population-based study of PPCM in South Korea, using the Korea National Health Insurance Claims Database of the Health Insurance Review and Assessment Service. Patients who fulfilled predefined diagnostic criteria for PPCM from January 1, 2010, to December 31, 2012, were identified from International Classification of Diseases, Tenth Revision, Clinical Modification codes. To discriminate PPCM from other causes of heart failure, we excluded subjects who already had heart failure-related International Classification of Diseases, Tenth Revision, Clinical Modification codes at least 1 year before delivery. During the study period, there were 1 404 551 deliveries in South Korea, and we excluded 20 159 patients who already had heart failure. In those, a total of 795 cases were identified as PPCM. Patients with PPCM were older, had a higher prevalence of preeclampsia and gestational diabetes mellitus, and were more likely to be primiparous and have multiple pregnancies. Moreover, cesarean section and pregnancy-related complications and in-hospital death were also more common in patients with PPCM. Intriguingly, a considerable number of heart failure cases (n=64; 8.1% of total PPCM) were noted between 5 and 12 months after delivery. Conclusions: The incidence of PPCM was 1 in 1741 deliveries in South Korea. Patients with PPCM were older, were more associated with primiparity and multiple pregnancy, had more pregnancy-related complications, and revealed higher in-hospital mortality than controls. The number of cases diagnosed as PPCM were decreased over time after delivery; however, a large number of patients were still noted through 12 months after delivery.

AB - Background: Peripartum cardiomyopathy (PPCM) is a rare disorder associated with pregnancy that can lead to life-threatening conditions. The incidence and clinical characteristics of this condition remain poorly understood. Methods and Results: We aimed to perform the first population-based study of PPCM in South Korea, using the Korea National Health Insurance Claims Database of the Health Insurance Review and Assessment Service. Patients who fulfilled predefined diagnostic criteria for PPCM from January 1, 2010, to December 31, 2012, were identified from International Classification of Diseases, Tenth Revision, Clinical Modification codes. To discriminate PPCM from other causes of heart failure, we excluded subjects who already had heart failure-related International Classification of Diseases, Tenth Revision, Clinical Modification codes at least 1 year before delivery. During the study period, there were 1 404 551 deliveries in South Korea, and we excluded 20 159 patients who already had heart failure. In those, a total of 795 cases were identified as PPCM. Patients with PPCM were older, had a higher prevalence of preeclampsia and gestational diabetes mellitus, and were more likely to be primiparous and have multiple pregnancies. Moreover, cesarean section and pregnancy-related complications and in-hospital death were also more common in patients with PPCM. Intriguingly, a considerable number of heart failure cases (n=64; 8.1% of total PPCM) were noted between 5 and 12 months after delivery. Conclusions: The incidence of PPCM was 1 in 1741 deliveries in South Korea. Patients with PPCM were older, were more associated with primiparity and multiple pregnancy, had more pregnancy-related complications, and revealed higher in-hospital mortality than controls. The number of cases diagnosed as PPCM were decreased over time after delivery; however, a large number of patients were still noted through 12 months after delivery.

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