Friday, May 29, 2015
Peripartum cardiomyopathy (PPCM) is a type of heart failure that arises within 1 month prior to or 5 months following childbirth. It is characterised by enlargement and weakening of the heart and at the time of giving birth is associated with a four to five times higher rate of stillbirth.
A new study has found that anxiety, mood disorders and depression doubles the risk of PPCM during childbirth whereas obesity increases the risk 1.7 fold. European researchers suggest that women be screened if they show shortness of breath, leg swelling as well as 5 risk factors for PPCM.
The researchers consulted patient records from all hospitals in California, New Jersey, Vermont, and Colorado between 2007-2013. They recruited 3.5 million mothers, of whom 486 had PPCM at the time of childbirth. The researchers had initially conducted a study with 4 million mothers, of whom 535 had PPCM. This group was also included in the present study.
The researchers had previously identified age 30 years or older, African ancestry, hypertension, anaemia, substance abuse, asthma, autoimmune disease, multiple gestations and preeclampsia/eclampsia as risk factors for PPCM. In the present study, they discovered 2 more risk factors, namely mood disorders and obesity.
“Obesity is a well known risk factor for heart failure including dilated cardiomyopathy via altered cardiac response to stress, abnormal thickening of the heart wall, abnormal use of energy by the heart, and several other factors. It is possible that the combination of obesity and pregnancy may put excessive stress on a heart that is less able to respond to stress and recovery from injury “said the researchers.
Mood disorders, especially depression, probably contribute to the increased risk of heart disease through excess cortisol and catecholamine secretion. In addition, these disorders may influence heart health through changes in diet, sleep, activity and prenatal care.
The scientists suggest early screening of women with 5 risk factors for PPCM and pregnancy related symptoms for early identification and treatment. However, since almost all treatments for PPCM could impose some risk of harm on the unborn child, it is very important to initiate a therapy only after due screening and review of experimental evidence.
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