Abstract：
BACKGROUND: Peripartum cardiomyopathy (PPCM) is a global disease with substantial morbidity and mortality. The aim of this study was to analyze to what extent socioeconomic factors were associated with maternal and neonatal outcomes.
METHODS: In 2011, >100 national and affiliated member cardiac societies of the European Society of Cardiology (ESC) were contacted to contribute to a global PPCM registry, under the auspices of the ESC EORP Programme. We investigated the characteristics and outcomes of women with PPCM and their babies according to individual and country-level sociodemographic factors (Gini index coefficient [GINI index], health expenditure [HE] and human developmental index [HDI]).
RESULTS: 739 women from 49 countries (Europe [33%], Africa [29%], Asia-Pacific [15%], Middle East [22%]) were enrolled. Low HDI was associated with greater left ventricular (LV) dilatation at time of diagnosis. However, baseline LV ejection fraction did not differ according to sociodemographic factors. Countries with low HE prescribed guideline-directed heart failure therapy less frequently. Six-month mortality was higher in countries with low HE; and LV non-recovery in those with low HDI, low HE and lower levels of education. Maternal outcome (death, re-hospitalization, or persistent LV dysfunction) was independently associated with income. Neonatal death was significantly more common in countries with low HE and low HDI, but was not influenced by maternal income or education attainment.
CONCLUSIONS: Maternal and neonatal outcomes depend on country-specific socioeconomic characteristics. Attempts should therefore be made to allocate adequate resources to health and education, to improve maternal and fetal outcomes in PPCM.
METHODS: In 2011, >100 national and affiliated member cardiac societies of the European Society of Cardiology (ESC) were contacted to contribute to a global PPCM registry, under the auspices of the ESC EORP Programme. We investigated the characteristics and outcomes of women with PPCM and their babies according to individual and country-level sociodemographic factors (Gini index coefficient [GINI index], health expenditure [HE] and human developmental index [HDI]).
RESULTS: 739 women from 49 countries (Europe [33%], Africa [29%], Asia-Pacific [15%], Middle East [22%]) were enrolled. Low HDI was associated with greater left ventricular (LV) dilatation at time of diagnosis. However, baseline LV ejection fraction did not differ according to sociodemographic factors. Countries with low HE prescribed guideline-directed heart failure therapy less frequently. Six-month mortality was higher in countries with low HE; and LV non-recovery in those with low HDI, low HE and lower levels of education. Maternal outcome (death, re-hospitalization, or persistent LV dysfunction) was independently associated with income. Neonatal death was significantly more common in countries with low HE and low HDI, but was not influenced by maternal income or education attainment.
CONCLUSIONS: Maternal and neonatal outcomes depend on country-specific socioeconomic characteristics. Attempts should therefore be made to allocate adequate resources to health and education, to improve maternal and fetal outcomes in PPCM.
摘要：
背景：围产期心肌病（PPCM）是一种具有大量发病率和死亡率的全球性疾病。这项研究的目的是分析社会经济因素在多大程度上与孕产妇和新生儿结局相关。
方法：2011年，与欧洲心脏病学会（ESC）的100个国家和附属心脏学会联系，为全球PPCM注册做出贡献。在ESCEORP计划的主持下。我们根据个人和国家一级的社会人口统计学因素调查了PPCM妇女及其婴儿的特征和结局（基尼指数系数[GINI指数]，卫生支出[HE]和人类发育指数[HDI])。
结果：来自49个国家的739名女性（欧洲[33%]，非洲[29%],亚太地区[15%]，中东[22%]）登记。在诊断时，低HDI与更大的左心室（LV）扩张相关。然而,根据社会人口统计学因素,基线LV射血分数无差异.低HE的国家规定指南指导心力衰竭治疗的频率较低。低HE国家的六个月死亡率较高；低HDI国家的LV无法恢复，低HE和较低的教育水平。产妇结局（死亡，再次住院,或持续性LV功能障碍）与收入独立相关。新生儿死亡在低HE和低HDI的国家明显更常见，但不受产妇收入或教育程度的影响。
结论：母婴结局取决于特定国家的社会经济特征。因此，应尝试为卫生和教育分配足够的资源，改善PPCM的母婴结局。
方法：2011年，与欧洲心脏病学会（ESC）的100个国家和附属心脏学会联系，为全球PPCM注册做出贡献。在ESCEORP计划的主持下。我们根据个人和国家一级的社会人口统计学因素调查了PPCM妇女及其婴儿的特征和结局（基尼指数系数[GINI指数]，卫生支出[HE]和人类发育指数[HDI])。
结果：来自49个国家的739名女性（欧洲[33%]，非洲[29%],亚太地区[15%]，中东[22%]）登记。在诊断时，低HDI与更大的左心室（LV）扩张相关。然而,根据社会人口统计学因素,基线LV射血分数无差异.低HE的国家规定指南指导心力衰竭治疗的频率较低。低HE国家的六个月死亡率较高；低HDI国家的LV无法恢复，低HE和较低的教育水平。产妇结局（死亡，再次住院,或持续性LV功能障碍）与收入独立相关。新生儿死亡在低HE和低HDI的国家明显更常见，但不受产妇收入或教育程度的影响。
结论：母婴结局取决于特定国家的社会经济特征。因此，应尝试为卫生和教育分配足够的资源，改善PPCM的母婴结局。
