Association of Anemia with Postpartum Cardiomyopathy in a Tertiary Care Hospital in Karachi

Abstract

Objectives: This study aimed to evaluate whether anemia is an independent risk factor for postpartum cardiomyopathy (PPCM) among women presenting at a tertiary care hospital in Karachi. Methodology: A case–control study was conducted in the Department of Cardiology, Civil Hospital, Karachi, between January and December 2024. A total of 100 postpartum women aged 18–40 years were enrolled, including 50 cases diagnosed with PPCM and 50 age- and parity-matched controls without PPCM. Hemoglobin levels were recorded at presentation, and data on gestational age, residence, and obstetric history were collected. Multivariate logistic regression was performed to estimate the adjusted odds ratio (OR) for PPCM associated with anemia (defined as hemoglobin <12 g/dL), while controlling for potential confounding variables. Results: Anemia was significantly more prevalent among PPCM cases (78.5%) compared to controls (52.6%) (p < 0.001). After adjustment for age, parity, gestational age, and residential status, anemia was associated with a threefold increased risk of PPCM (adjusted OR 3.2; 95% CI: 1.8–5.7; p < 0.001). No significant variation in anemia prevalence was observed across subgroups defined by age, parity, gestational age, or residence. Conclusion: These findings demonstrate a strong and independent association between anemia and PPCM. We recommend routine screening and early treatment of anemia during pregnancy as part of comprehensive maternal health services. Strengthening nutritional programs and integrating cardiovascular risk assessments into antenatal care may help reduce the burden of PPCM in similar low-resource settings.