Peripartum cardiomyopathy is a rare but serious cardiac complication of pregnancy which arises in the last antepartum month or the first five postpartum months. Criteria for peripartum myopathy include left ventricular systolic dysfunction and the absence of another identifiable cause for heart failure [1]. A prior study of cross-sectional national discharge data from 2004 to 2011 found that risk for peripartum cardiomyopathy may be increasing along with complications such as cardiogenic shock, use of mechanical circulatory support, and in-hospital mortality [2]. Subsequent studies have demonstrated similar trends [3]. Risk may be increasing in part because known risk factors such as hypertensive disorders of pregnancy are increasing at the population level [4], [5], [6], [7], [8], [9], [10], [11].

Most national studies evaluating peripartum cardiomyopathy analyze cross-sectional data and there is limited cohort data evaluating diagnoses and risk factors across time from delivery hospitalizations through postpartum readmissions. Because peripartum cardiomyopathy is diagnosed in relation to delivery, cohort data may provide more accurate estimates in trends, risk factors, and outcomes. Given that updated data characterizing outcomes may be of clinical and public health importance, the purposes of this study were to evaluate risk for peripartum cardiomyopathy during delivery and postpartum hospitalizations and to analyze associated trends, risk factors, and clinical outcomes.