Top Things to Know: Heart Failure Occurring in the Perinatal Period
Updated: June 24, 2026
Prepared by Anne Leonard MPH, BSN, RN, National Senior Director Science and Medicine, American Heart Association
- Heart failure (HF) in the perinatal period remains ambiguous in definition and management despite its recognition as a unique disease state.
- The true incidence and prevalence of heart failure or left ventricular systolic dysfunction (LVSD) during pregnancy and the postpartum period are unknown, although a prevalence as high as 1% to 2% has been reported in the general adult US population.
- Delays in the recognition and diagnosis of heart failure during the perinatal period contribute to adverse maternal outcomes.
- Assessment of heart failure in pregnant or postpartum patients can be challenging because common symptoms—such as dyspnea, exercise intolerance, fatigue, and lower-extremity edema—overlap with normal physiological changes of pregnancy and may be overlooked as signs of HF.
- Cardiomyopathies in pregnancy account for a sub¬stantial portion of cardiovascular conditions in pregnancy, with dilated cardiomyopathy and peripartum cardiomy¬opathy (PPCM) accounting for ≈92% of all reported cases.
- Assessment of cardiac function and cardiogenic pulmonary or systemic congestion include modalities such as electrocardiography, echocardiography, serum biomarkers, magnetic resonance imaging, and chest radiography.
- The epidemiology and the burden of HF with left ventricular systolic dysfunction in the perinatal period is examined within the areas of preexisting HF in the perinatal period, de novo HF, peripartum cardiomyopathy (PPCM), and other cardiomyopathy types such as dilated cardiomyopathy.
- Evaluation and diagnosis of perinatal HF include screening and risk assessment during pregnancy, recognition, and the diagnosis of HF in the postpartum period.
- Management of heart failure across the perinatal period includes preconception, pregnancy, labor and delivery, early postpartum, and late postpartum phases.
- This statement discusses the gaps and future directions for this serious and life-threatening condition in women at risk or who have HF in the perinatal period.
Citation
Adedinsewo DA, Brown HL, Hameed AB, McNamara D, Mogos MF, Skowronski J, Vaught A, Meng M-L, Ogunniyi MO, Reza N; on behalf of the American Heart Association Women’s Health Science Committee of the Council on Clinical Cardiology; Council on Cardiovascular Surgery and Anesthesia; and Council on Cardiovascular and Stroke Nursing. Heart failure occurring in the perinatal period: a scientific statement from the American Heart Association. Circulation. Published online June 24, 2026. doi: 10.1161/CIR.0000000000001450