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围产期心肌病的全球发病率与孕产妇总死亡率

Worldwide Incidence of Peripartum Cardiomyopathy and Overall Maternal Mortality.

作者信息

Isogai Toshiaki, Kamiya Chizuko A

机构信息

Department of Cardiology, Tokyo Metropolitan Tama Medical Center.

Department of Perinatology and Gynecology, National Cerebral and Cardiovascular Center.

出版信息

Int Heart J. 2019 May 30;60(3):503-511. doi: 10.1536/ihj.18-729. Epub 2019 Apr 25.

Abstract

Peripartum cardiomyopathy (PPCM) is a specific cardiomyopathy in which heart failure develops due to reduced myocardial contraction during pregnancy or in the postpartum period in women without a previous history of heart disease. The epidemiology of PPCM has been reported in various countries and areas, and the incidence of PPCM differed among these reports. The incidence was highest (1 in 102 deliveries) in Nigeria and lowest (1 in 15,533 births) in Japan. The incidence was higher in African-Americans than in other races in several reports from the United States, and was also high in African countries and Haiti, indicating that the risk for PPCM is highest in the black race. However, the study design and definition of PPCM differ among studies, and these differences may influence the incidence. Moreover, the incidence of PPCM and the maternal mortality rate were well correlated. Since maternal mortality reflects the level of perinatal health care and hygiene, this finding suggests that the extent of perinatal care is partly related to the incidence of PPCM, which reflects heart failure and cardiomyopathy of unknown cause in women.

摘要

围产期心肌病(PPCM)是一种特殊的心肌病,在无心脏病史的女性中,妊娠期间或产后因心肌收缩力下降而发生心力衰竭。不同国家和地区都报道过PPCM的流行病学情况,这些报道中PPCM的发病率有所不同。发病率在尼日利亚最高(每102次分娩中有1例),在日本最低(每15533例出生中有1例)。在美国的几份报告中,非裔美国人的发病率高于其他种族,在非洲国家和海地也很高,这表明黑人种族患PPCM的风险最高。然而,不同研究中PPCM的研究设计和定义存在差异,这些差异可能会影响发病率。此外,PPCM的发病率与孕产妇死亡率密切相关。由于孕产妇死亡率反映了围产期保健和卫生水平,这一发现表明围产期护理的程度与PPCM的发病率部分相关,PPCM反映了女性不明原因的心力衰竭和心肌病。

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