Introduction The primary concern for women who have experienced peripartum cardiomyopathy (PPCM) is the safety of a subsequent pregnancy (SSP). To maximie decision-making, facilitate effective patient counselling, and ultimately improve maternal and fetal outcomes as a whole, it is critical to comprehend the outcomes of SSP in women who have previously experienced PPCM. This study aimed to evaluate the outcomes of SSP in women with PPCM. Methods Three databases (PubMed, Scopus, and ScienceDirect) were used to identify relevant studies prior to 17 October 2023. A total of 662 studies were reviewed. Following the abstract and full-text screenings, 18 observational studies were included, out of which 2 were deemed suitable for inclusion in this meta-analysis. The quality assessment was conducted using the Newcastle-Ottawa Scale. Results This study has a total of 487 SSPs. Although recovered left ventricular (LV) function before entering SSP has the potential to be a beneficial prognostic factor, recovered LV function still has a substantial risk of relapse. The mortality rate of PPCM in an SSP ranged from 0% to 55.5%. Persistent LV dysfunction was significantly associated with an increased mortality rate (OR 13.17; 95% CI 1.54 to 112.28; p=0.02) and lower LV ejection fraction (MD −12.88; 95% CI −21.67 to −4.09; p=0.004). Diastolic and right ventricular functions remained unchanged before SSP and at follow-up. The majority of the SSP was observed alongside hypertension, while pre-eclampsia emerged as the predominant hypertensive complication in most studies. Conclusion SSP increases the risk of relapse and mortality in women with a previous history of PPCM. Persistent LV dysfunction prior to the SSP has a higher mortality risk compared with recovered LV function. SSP was also associated with the worsening of LV echocardiography parameters. All data relevant to the study are included in the article or uploaded as online supplemental information.

中文翻译：

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围产期心肌病女性随后妊娠的结果：系统评价和荟萃分析

简介 对于患有围产期心肌病 (PPCM) 的女性来说，最关心的是后续妊娠 (SSP) 的安全性。为了最大限度地做出决策、促进有效的患者咨询并最终改善孕产妇和胎儿的整体结局，了解 SSP 对之前经历过 PPCM 的女性的结局至关重要。本研究旨在评估 PPCM 女性 SSP 的结果。方法 使用三个数据库（PubMed、Scopus 和 ScienceDirect）来识别 2023 年 10 月 17 日之前的相关研究。总共审查了 662 项研究。经过摘要和全文筛选后，纳入了 18 项观察性研究，其中 2 项被认为适合纳入本荟萃分析。使用纽卡斯尔-渥太华量表进行质量评估。结果 本研究共有 487 个 SSP。尽管在进入 SSP 之前恢复左心室 (LV) 功能有可能成为有益的预后因素，但恢复的 LV 功能仍然存在很大的复发风险。 SSP 中 PPCM 的死亡率范围为 0% 至 55.5%。持续性左心室功能障碍与死亡率增加（OR 13.17；95% CI 1.54至112.28；p=0.02）和左心室射血分数降低（MD −12.88；95% CI -21.67至-4.09；p=0.004）显着相关。 SSP 之前和随访期间舒张功能和右心室功能保持不变。大多数 SSP 与高血压一起观察到，而在大多数研究中，先兆子痫是主要的高血压并发症。结论 SSP 会增加有 PPCM 病史的女性复发和死亡的风险。与恢复的左心室功能相比，SSP 之前持续的左心室功能障碍具有更高的死亡风险。 SSP 还与左心室超声心动图参数恶化相关。与研究相关的所有数据都包含在文章中或作为在线补充信息上传。