Incidence, risk factors, and clinical outcomes of peripartum cardiomyopathy in Hong Kong
Bibliographic record
Abstract
INTRODUCTION: Peripartum cardiomyopathy (PPCM) is an uncommon but serious form of heart failure affecting women during late pregnancy or early postpartum. This territory-wide multicentre retrospective study aimed to evaluate the local incidence, risk factors, and clinical outcomes, including subsequent pregnancies, in Hong Kong. METHODS: Medical records were retrospectively reviewed for women who delivered at all public hospitals between 1 January 2013 and 31 December 2022 and met the 2010 European Society of Cardiology Working Group criteria for PPCM. Regression analysis was performed to investigate maternal risk factors. RESULTS: Thirty Asian women were diagnosed with PPCM, corresponding to an incidence of 1 in 11 179 live births. Eleven (36.7%) had antepartum onset of symptoms, and 25 (83.3%) were diagnosed after childbirth, most presenting with severe symptoms (90%). The median left ventricular ejection fraction was 30% (range, 10%-44%). Notable complications included cardiogenic shock (10%), respiratory failure (23.3%), acute renal failure (23.3%), and thromboembolism (23.3%). Most women received guideline-directed heart failure therapy. At 12 months, all-cause mortality was 6.7%, and cardiac recovery occurred in 60%. Eleven women had 13 subsequent pregnancies (three miscarriages, five terminations, and five live births). There were no maternal deaths or cases of recurrent PPCM. Genetic testing identified potentially pathogenic variants in at least 10% of women. Antenatal anaemia (adjusted odds ratio [OR]=13.04; 95% confidence interval [95% CI]=3.72-45.70) and hypertensive disorders of pregnancy (adjusted OR=38.00; 95% CI=9.66-149.52) were associated with higher odds of PPCM. CONCLUSION: This study highlights the substantial morbidity and mortality associated with PPCM. Genetic testing may aid in risk stratification and prognostication.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.004 | 0.010 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.002 | 0.001 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.002 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".