We sought to evaluate the rates and predictors of contraception in reproductive age women with cardiomyopathy.METHODS:
A retrospective cohort study of women age 18-45 who were admitted with a known diagnosis of cardiomyopathy at a single urban tertiary care center between 5/2010 and 6/2016 was performed. Clinical charts were reviewed for clinical course, medication use and demographic data. The data was analyzed using chi-square and Mann Whitney U test. P less than 0.05 was considered significant.RESULTS:
Among the 45 women with cardiomyopathy, 29% had an ejection fraction ≤30% and 80% were taking a medication recognized as potentially teratogenic. These included ACE inhibitors, Coumadin and others. Only 37% of the women were taking birth control. These included tubal ligation (n=11) and long acting reversible contraception (n=2). Women with a hysterectomy (n=4) were considered to have contraception. Women with contraception when compared to women without contraception were more likely to be married (53 vs 14%, p=0.04) and have a higher BMI (33 vs 27 kg/m2, p=0.04) but there was no difference in the utilization of public insurance (82 vs 75%, p=.71). They were more likely to have chronic hypertension (94 vs 50%, p=0.003) but less likely to be taking a medication which was potentially teratogenic (89 vs 64%, p=0.04). Overall, 30% of women taking a potentially teratogenic medication were on birth control.CONCLUSION:
Among women with cardiomyopathy, contraception is underutilized. A focus in this population is warranted in order to prevent maternal and infant morbidity and mortality.