Abstract
Peripartum cardiomyopathy (PPCM) is a rare yet life-threatening form of heart failure that occurs late in pregnancy or within five months postpartum, in the absence of other identified causes [1]. The causes of PPCM remain poorly understood. PPCM can result in severe maternal complications including death [1,2]. This study examined trends in with PPCM-associated mortality in the U.S. from 2018 to 2023, with a focus on differences by age group, race and ethnicity.
This serial cross-sectional study used death certificates data from the U.S. Centers for Disease Control and Prevention Wide-ranging Online for Epidemiologic Research (CDC WONDER). Deaths from 2018 to 2023 with PPCM listed as multiple cause of death were identified using the International Classification of Diseases, 10th Revision (ICD-10) code O90.3 and stratified by age group, race and ethnicity, and year. Crude mortality rate (CMR) and rate ratios (RR) with 95% confidence interval (CI) per 100,000 population were calculated to assess disparities.
From 2018 to 2023, there were 257 PPCM-associated deaths (0.013 deaths per 100,000 population [95% CI, 0.013-0.015]) among pregnant and postpartum women in the U.S., of which 167 (65%) had PPCM listed as the underlying cause. CMR were 1.7-fold higher in 2020 and 2023 (CMR: 0.015) compared with 2018 (CMR: 0.009). PPCM CMR was significantly higher among women aged 25–34 years (RR = 4.444, 95%CI: 2.803–7.048) and 35–44 years (RR = 4.000, 95%CI: 2.519–6.353) compared with women aged 45-54 years. Non-Hispanic Black women experienced a 6.4-fold higher CMR (RR: = 6.375, 95%CI: 4.891–8.325) than Non-Hispanic White women, whereas Hispanic/Latino women had a lower CMR (RR = 0.750, 95%CI: 0.476–1.181). No PPCM-associated deaths were reported among Native Hawaiian or Other Pacific Islander women, and only 11 deaths occurred among other racial and ethnic groups.
This study found that younger women aged 25–34 years are also at risk for PPCM. These preventable disparities emphasize the need for policies and interventions that promote awareness and address social determinants of maternal health. Urgent efforts should focus on strengthening health systems, ensuring timely detection, management and follow-up care. Education and community outreach initiatives would be crucial to improving maternal outcomes and reducing PPCM-associated mortality. Nurses should play a pivotal role in counseling at-risk women about future pregnancies.
Notes
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References:
1. Sliwa K, Petrie MC, Hilfiker Kleiner D, Mebazaa A, Jackson A, Johnson MR, van der Meer P, Mbakwem A, Bauersachs J. Long term prognosis, subsequent pregnancy, contraception and overall management of peripartum cardiomyopathy: practical guidance paper from the Heart Failure Association of the European Society of Cardiology Study Group on Peripartum Cardiomyopathy. European journal of heart failure. 2018 Jun;20(6):951-62. doi.org/10.1002/ejhf.1178
2. Peripartum Cardiomyopathy and Pregnancy Issues. National heart, Lung, and Blood Institute. https://www.nhlbi.nih.gov/health/cardiomyopathy/pregnancy. Updated February 04, 2025. Accessed October 31, 2025.
Sigma Membership
Beta Beta (Houston)
Type
Presentation
Format Type
Text-based Document
Study Design/Type
Cross-Sectional
Research Approach
Quantitative Research
Keywords:
Sustainable Development Goals, Primary Care, Health Equity or Social Determinants of Health, Cardiomyopathy, Perinatal Period, Maternal Mortality
Recommended Citation
Havor, Essi M.; Hayes, Alexis E.; Sorkpor, Setor K.; Ouner, Jerry John; and Mgbere, Osaro, "Trends and Disparities in Peripartum Cardiomyopathy-Associated Mortality in the US, 2018–2023" (2026). International Nursing Research Congress (INRC). 242.
https://www.sigmarepository.org/inrc/2026/presentations_2026/242
Conference Name
37th International Nursing Research Congress
Conference Host
Sigma Theta Tau International
Conference Location
Toronto, Ontario, Canada
Conference Year
2026
Rights Holder
All rights reserved by the author(s) and/or publisher(s) listed in this item record unless relinquished in whole or part by a rights notation or a Creative Commons License present in this item record. All permission requests should be directed accordingly and not to the Sigma Repository. All submitting authors or publishers have affirmed that when using material in their work where they do not own copyright, they have obtained permission of the copyright holder prior to submission and the rights holder has been acknowledged as necessary.
Review Type
Abstract Review Only: Reviewed by Event Host
Acquisition
Proxy-submission
Date of Issue
2026-08-29
Trends and Disparities in Peripartum Cardiomyopathy-Associated Mortality in the US, 2018–2023
Toronto, Ontario, Canada
Peripartum cardiomyopathy (PPCM) is a rare yet life-threatening form of heart failure that occurs late in pregnancy or within five months postpartum, in the absence of other identified causes [1]. The causes of PPCM remain poorly understood. PPCM can result in severe maternal complications including death [1,2]. This study examined trends in with PPCM-associated mortality in the U.S. from 2018 to 2023, with a focus on differences by age group, race and ethnicity.
This serial cross-sectional study used death certificates data from the U.S. Centers for Disease Control and Prevention Wide-ranging Online for Epidemiologic Research (CDC WONDER). Deaths from 2018 to 2023 with PPCM listed as multiple cause of death were identified using the International Classification of Diseases, 10th Revision (ICD-10) code O90.3 and stratified by age group, race and ethnicity, and year. Crude mortality rate (CMR) and rate ratios (RR) with 95% confidence interval (CI) per 100,000 population were calculated to assess disparities.
From 2018 to 2023, there were 257 PPCM-associated deaths (0.013 deaths per 100,000 population [95% CI, 0.013-0.015]) among pregnant and postpartum women in the U.S., of which 167 (65%) had PPCM listed as the underlying cause. CMR were 1.7-fold higher in 2020 and 2023 (CMR: 0.015) compared with 2018 (CMR: 0.009). PPCM CMR was significantly higher among women aged 25–34 years (RR = 4.444, 95%CI: 2.803–7.048) and 35–44 years (RR = 4.000, 95%CI: 2.519–6.353) compared with women aged 45-54 years. Non-Hispanic Black women experienced a 6.4-fold higher CMR (RR: = 6.375, 95%CI: 4.891–8.325) than Non-Hispanic White women, whereas Hispanic/Latino women had a lower CMR (RR = 0.750, 95%CI: 0.476–1.181). No PPCM-associated deaths were reported among Native Hawaiian or Other Pacific Islander women, and only 11 deaths occurred among other racial and ethnic groups.
This study found that younger women aged 25–34 years are also at risk for PPCM. These preventable disparities emphasize the need for policies and interventions that promote awareness and address social determinants of maternal health. Urgent efforts should focus on strengthening health systems, ensuring timely detection, management and follow-up care. Education and community outreach initiatives would be crucial to improving maternal outcomes and reducing PPCM-associated mortality. Nurses should play a pivotal role in counseling at-risk women about future pregnancies.
Description
This cross-sectional study described peripartum cardiomyopathy (PPCM) deaths in the U.S. From 2018–2023, there were 257 PPCM deaths (0.013 deaths per 100,000 population). PPCM death rates were 1.7-fold higher in 2020 and 2023 than in 2018. The crude mortality rates were significantly higher among women aged 25–34 (RR = 4.444, 95%CI: 2.803–7.048) than women aged 45–44 years. Non-Hispanic Black women experienced a 6.4-fold higher death rates than White women.