James D. Fett, MD; Len G. Christie, MD; Joseph G. Murphy, MD
Acknowledgments: The authors thank the patients, volunteers, and staff at Hôpital Albert Schweitzer.
Grant Support: No grants were received. Funding was provided through charitable contributions (Pierre Paulette Peripartum Cardiomyopathy Fund) that are separate from the operating budget of the Hôpital Albert Schweitzer.
Potential Financial Conflicts of Interest: None disclosed.
Requests for Single Reprints: Joseph G. Murphy, MD, Division of Cardiovascular Diseases, Mayo Clinic, 200 First Street SW, Rochester, MN 55905; e-mail, firstname.lastname@example.org.
Current Author Addresses: Dr. Fett: PPCM Project, Hôpital Albert Schweitzer, Deschapelles, Haiti, c/o 611 Sumner Avenue, Aberdeen, WA 98520.
Dr. Christie: Oregon Cardiovascular Teachings Ltd., 1461 Hilyard Street, Eugene, OR 97405.
Dr. Murphy: Division of Cardiovascular Diseases, Mayo Clinic, 200 First Street SW, Rochester, MN 55905.
Author Contributions: Conception and design: J.D. Fett.
Analysis and interpretation of the data: J.D. Fett, L.G. Christie, J.G. Murphy.
Drafting of the article: J.D. Fett, J.G. Murphy.
Critical revision of the article for important intellectual content: J.D. Fett, J.G. Murphy.
Final approval of the article: J.D. Fett, L.G. Christie, J.G. Murphy.
Provision of study materials or patients: J.D. Fett, L.G. Christie.
Statistical expertise: J.D. Fett, J.G. Murphy.
Obtaining of funding: J.D. Fett, L.G. Christie, J.G. Murphy.
Administrative, technical, or logistic support: J.D. Fett, L.G. Christie, J.G. Murphy.
Collection and assembly of data: J.D. Fett, L.G. Christie.
Fett J., Christie L., Murphy J.; Brief Communication: Outcomes of Subsequent Pregnancy after Peripartum Cardiomyopathy: A Case Series from Haiti. Ann Intern Med. 2006;145:30-34. doi: 10.7326/0003-4819-145-1-200607040-00007
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Published: Ann Intern Med. 2006;145(1):30-34.
Peripartum cardiomyopathy (PPCM) is a poorly characterized cause of heart failure in previously healthy women, with onset in late pregnancy or early in the postpartum period. We have reported (1-3) the high incidence of PPCM in the Hôpital Albert Schweitzer (4) district of Haiti: 1 case per 300 live births (10 times the incidence in the United States). Other outcome features reported in this population (3) include a mortality rate of 15.3% over a 5-year observational period for 98 prospectively identified patients and a left ventricular systolic function recovery rate of 28% in 92 patients who were observed for at least 6 months after diagnosis. Important additional concerns of clinical research in PPCM are maternal survival and tolerance of future pregnancies. In 1 of few articles that examine this, Elkayam and colleagues (5) reported a retrospective multicenter case study from the United States that underlined the high level of risk in subsequent pregnancies. We report the outcome of subsequent pregnancies in a case-series study from Haiti, an island nation that is burdened by poverty, political instability, and massive health problems.
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