Gestational Weight Gain in a Woman with Peripartum Cardiomyopathy

Abstract

Greater gestational weight gain (GWG) may be a risk factor for peripartum cardiomyopathy (PPCM). In counseling, women with a prior history of PPCM associated with greater GWG should be advised to avoid excessive GWG in subsequent pregnancies. The third pregnancy occurred in a 36-year-old Japanese woman with height of 1.48 m and left ventricular ejection fraction (LVEF) of 62% following the first and second pregnancies complicated with PPCM and spontaneous abortion, respectively. She exhibited GWG of 14.7 kg (from 37.0 to 51.7 kg) and normal or nearly normal plasma B-type natriuretic peptide levels and LVEF (>55%) throughout the current pregnancy. In her first pregnancy at the age of 33 years, extraordinary GWG of 30 kg (from 38.5 to 69.1 kg) preceded PPCM with nadir LVEF of 22% at 6 weeks postpartum followed by more than 18-month LVEF of <55%.

Pre-pregnancy Obesity and the Risk of Peripartum Cardiomyopathy

“…We recognize that pre-pregnancy BMI is only one aspect of women's weight and further studies are needed to assess the relationship between gestational weight gain and risk of peripartum cardiomyopathy. [38][39][40][41] Our study used California data, which may limit the generalizability of the results. However, one in eight U.S. births occur in California, 42 and California is a state with relatively diverse demography and geography.…”