Division of Cardiovascular Medicine, Department of Medicine, Stony Brook University Medical Center, State University of New York, Stony Brook, Nichols road, 11794 NY, United States of America.
Division of Cardiovascular Medicine, Mayo Clinic, 55905 Rochester, MN, USA.
Arch Cardiovasc Dis. 2019 Mar;112(3):187-198. doi: 10.1016/j.acvd.2018.10.002. Epub 2018 Dec 26.
There is limited information about differences in maternal deaths from peripartum cardiomyopathy (PPCM) between advanced and developing countries. To review the literature to define the global prevalence of death from PPCM, and to determine the differences in PPCM mortality rates and risk factors between advanced and developing countries. Studies in the English language reporting mortality data on patients with PPCM were included from searches of MEDLINE, Embase, CINAHL, the Cochrane Library, the Web of Science Core Collection and Scopus from 01 January 2000 to 11 May 2016. Of the 4294 articles identified, 1.07% were included. The primary outcome was death; rates of heart transplant, acute myocardial infarction, heart failure, arrhythmia, cerebrovascular events, embolism and cardiac arrest were recorded. Studies were categorized as having been conducted in advanced or developing countries. Data from 46 studies, 4925 patients and 13 countries were included. There were 22 studies from advanced countries (n=3417) and 24 from developing countries (n=1508); mean follow-up was 2.6 (range 0-8.6) years. Overall mortality prevalence was 9% (95% confidence interval [CI] 6-11%). The mortality rate in developing countries (14%, 95% CI 10-18%) was significantly higher than that in advanced countries (4%, 95% CI 2-7%). There was no difference in the prevalence of risk factors (chronic hypertension, African descent, multiple gestation and multiparity) between advanced and developing countries. Studies with a higher prevalence of women of African descent had higher death rates (correlation coefficient 0.29, 95% CI 0.13-0.52). The risk of death in women with PPCM was higher in developing countries than in advanced countries. Women of African descent had an increased risk of death.
关于围产期心肌病 (PPCM) 导致的孕产妇死亡在发达国家和发展中国家之间的差异，相关信息有限。本研究旨在回顾文献以明确 PPCM 的全球死亡率，并确定发达国家和发展中国家之间 PPCM 死亡率和危险因素的差异。通过检索 MEDLINE、Embase、CINAHL、Cochrane 图书馆、Web of Science 核心合集和 Scopus，从 2000 年 1 月 1 日至 2016 年 5 月 11 日，纳入了报道 PPCM 患者死亡数据的英文研究。在确定的 4294 篇文章中，有 1.07%的文章被纳入。主要结局为死亡；记录了心脏移植、急性心肌梗死、心力衰竭、心律失常、脑血管事件、栓塞和心脏骤停的发生率。研究分为在发达国家和发展中国家进行的。共纳入 46 项研究、4925 例患者和 13 个国家的数据。其中 22 项研究来自发达国家（n=3417），24 项来自发展中国家（n=1508）；平均随访时间为 2.6 年（范围 0-8.6 年）。总体死亡率为 9%（95%置信区间 6-11%）。发展中国家的死亡率（14%，95%置信区间 10-18%）明显高于发达国家（4%，95%置信区间 2-7%）。发达国家和发展中国家之间的危险因素（慢性高血压、非裔、多胎妊娠和多产）患病率没有差异。非裔妇女比例较高的研究死亡率更高（相关系数 0.29，95%置信区间 0.13-0.52）。发展中国家 PPCM 妇女的死亡风险高于发达国家。非裔妇女的死亡风险增加。
