Introduction Peripartum cardiomyopathy (PPCM) is a cardiovascular condition that occurs during late pregnancy or within five months postpartum, often leading to poor clinical outcomes. The global incidence of PPCM is estimated to range from 1 in 100 to 1 in 20,000 live births, depending on the population and geographic region. Identifying predictors of poor clinical outcomes in PPCM is essential for optimizing care management and improving the prognosis of affected patients.

Methods A literature search was conducted in the PubMed database using the keywords (((peripartum cardiomyopathy) OR (PPCM)) AND (outcome)) AND (predictor), limited to articles published in English between 2014 and 2024. The study focusing on predictors to assess outcome of PPCM patients.

Results Eleven studies met the inclusion criteria, providing data on 1259 patients with PPCM, which revealed that elevated heart rate (adjusted odds ratio 5.35, confidence interval 1.23–23.28, p=0.025), high N-terminal pro-hormone brain natriuretic peptide (NT-proBNP) levels (log-rank test p-value 0.018), and low systolic blood pressure (p=0.0023) are significant predictors of mortality and reduced left ventricular ejection fraction (LVEF). Sinus tachycardia and prolonged QT intervals (QTc) on baseline electrocardiography (ECG) are also associated with poor outcomes (OR 6.34, 95% CI 1.06–37.80, p=0.043). Furthermore, right ventricular dysfunction and elevated pulmonary artery systolic pressure correlate with adverse events such as death or recurrent hospitalizations (95% confidence interval: 1.11–9.28, p=0.03). Additionally, a low Prognostic Nutritional Index (PNI) is a key indicator of poor outcomes (95% confidence interval 0.729–0.888, p<0.001).

Discussion These findings indicate that factors such as heart rate, NT-proBNP levels, systolic blood pressure, and PNI can provide valuable insights into the prognosis of PPCM patients. Moreover, ECG abnormalities, including prolonged QTc and sinus tachycardia, along with right ventricular dysfunction and systolic pulmonary artery pressure, serve as important prognostic indicators for predicting clinical outcomes.

Conclusion A comprehensive assessment of these factors can enhance the ability to predict outcomes and tailor treatment strategies for PPCM patients. Close monitoring of these parameters is crucial for improving clinical outcomes and optimizing the management of PPCM.