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Poster Session 4

Category: Medical/Surgical/Diseases/Complications

Poster Session 4

(1217) Peripartum cardiomyopathy: impact of delivery mode on severe maternal morbidity and cardiopulmonary outcomes

Thursday, February 12, 2026

3:30 PM - 5:00 PM

Submitting Author and Presenting Author(s)

Prisca C. Diala, MD (she/her/hers)

Department of Obstetrics and Gynecology, David Geffen School of Medicine at University of California, Los Angeles (UCLA)
Los Angeles, California, United States

Coauthor(s)

Vanessa Kirschner, BS

David Geffen School of Medicine at University of California, Los Angeles (UCLA)
LOS ANGELES, California, United States
JC

Jiayue Chen, MPH

Department of Urology, David Geffen School of Medicine at University of California, Los Angeles (UCLA)
Los Angeles, California, United States
LK

Lorna Kwan, BS, MPH

Principal Statistician
Department of Urology, David Geffen School of Medicine at University of California, Los Angeles (UCLA)
Los Angeles, California, United States
Jeannette Lin, MD (she/her/hers)

Associate Clinical Professor of Medicine
Division of Cardiology, Department of Medicine, Ahmanson/UCLA Adult Congenital Heart Disease Center, David Geffen School of Medicine at University of California, Los Angeles (UCLA)
Los Angeles, California, United States
Yalda Afshar, MD, PhD (she/her/hers)

David Geffen School of Medicine at University of California, Los Angeles (UCLA)
Los Angeles, California, United States

Objective:
To evaluate the impact of delivery mode on severe maternal morbidity (SMM) and cardiopulmonary outcomes in peripartum cardiomyopathy (PPCM).

Study Design:
This was a retrospective cohort study of hospitalized patients with antepartum diagnosis of PPCM using the National Inpatient Sample who delivered in the United States between 2016 and 2020. The primary outcome was a composite of SMM, rigorously defined and stratified by mode of birth (planned or unplanned/intrapartum). Secondary outcomes included rates of major adverse cardiopulmonary events. Multivariate regression models were adjusted for key demographic and clinical confounders.

Results:
Among 3,250 hospitalized patients with PPCM, nearly 60% underwent a trial of labor (TOL), yet 66% ultimately had a cesarean birth (Fig 1). There was no significant difference in composite SMM between intended vaginal birth or planned cesarean birth (aOR: 1.14; 95% CI: 0.79-1.63, Fig 2). However, when analyzed by actual mode of birth, cesarean birth, planned or unplanned, was associated with a two-fold increase in SMM compared to vaginal birth (aOR: 1.76; 95% CI: 1.22-2.55, Fig 2). Rates of adverse cardiopulmonary outcomes, including arrhythmia, cardiogenic shock, and pulmonary embolism, did not differ by mode of birth (p >0.05).

Conclusion:

In a large nationwide contemporary cohort of delivery outcomes in PPCM, our findings challenge the reflexive use of cesarean birth in this population. Cesarean birth, regardless of intent (planned or unplanned/intrapartum) confers a two-fold increase in SMM compared to vaginal birth. These findings provide evidence to support a trial of labor in appropriately selected patients with PPCM and highlight the need for individualized multi-disciplinary delivery planning to improve maternal outcomes for a vulnerable obstetrical population.