Atanfu, Thomas

Abstract Background: Peripartum cardiomyopathy (PPCM) is an important cause of maternal heart failure associated with variable recovery and significant morbidity and mortality. Outcomes significantly differ from region to region with lower in high-income settings and very high in Africa and Asia. However, data from Ethiopia remain limited, particularly regarding one-year clinical and echocardiographic outcomes. Objective: To assess the one-year clinical and echocardiographic outcomes of patients diagnosed with peripartum cardiomyopathy and to identify factors associated with poor outcomes. Methods: A multicenter retrospective cohort study was conducted across selected tertiary and private hospitals in Addis Ababa, Ethiopia. All women diagnosed with PPCM between January 2020 and December 2024 were included using a census sampling approach. Data were extracted from electronic medical records and supplemented by phone follow-up when necessary. The primary outcomes were one-year mortality, heart failure–related hospital admission, and one-year ejection fraction recovery. A composite poor outcome was defined as death, hospital admission, or non-recovery of left ventricular function. Results: A total of 61 patients were included in the analysis. Five patients (8.2%) died within one year of diagnosis. Among patients with available one-year echocardiographic data, 50.8% achieved recovery of left ventricular systolic function. The remaining patients demonstrated either partial recovery or persistent systolic dysfunction. Higher baseline New York Heart Association (NYHA) functional class (III–IV) was associated with poorer outcomes, including lower rates of ejection fraction recovery and increased likelihood of adverse clinical outcomes. Conclusion: PPCM in this Ethiopia’s associated with measurable mortality, significant morbidity and heterogeneous recovery of left ventricular function at one year. Only about half of patients achieved full recovery, with worse outcomes observed among those presenting with advanced heart failure and severely reduced ejection fraction. Outcomes appear more favorable than those reported in some African settings but remain inferior to those observed in high-income countries.