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Primary research studies of any design providing data for any of our outcomes of interest with greater than five subsequent pregnancies were eligible for inclusion. Primary outcomes included relapse of cardiac failure in the first subsequent pregnancy and death during any subsequent pregnancy. Secondary outcomes included a range of maternal and fetal outcomes. Proportional meta\u2010analysis, applying a random effects model, was performed using R software.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Twenty\u2010nine studies involving 779 women were included, performed across 13 countries. The risk of relapse of cardiac failure in the first subsequent pregnancy (20 studies, 376 women) was 32%, 95% confidence interval [CI] 0.23\u20130.43. In those with recovered (11 studies, 123 pregnancies) and non\u2010recovered (10 studies, 55 pregnancies) cardiac function at subsequent pregnancy outset, the risk of cardiac failure relapse was 24%, 95% CI 0.16\u20130.35 and 36%, 95% CI 0.24\u20130.50, respectively. There was a high chance of preterm birth &lt;37\u2009weeks (12 studies, 212 pregnancies) at 22%, 95% CI 0.17\u20130.29.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Subsequent pregnancy after peripartum cardiomyopathy presents significant maternal and fetal risks. This study provides quantification of risks to begin to fill the current evidence gap, however is limited by the paucity of existing primary research investigating this population. Robust observational studies of current practice are needed to provide answers in specific populations.<\/jats:p><\/jats:sec>","DOI":"10.1111\/aogs.15117","type":"journal-article","created":{"date-parts":[[2025,5,1]],"date-time":"2025-05-01T05:39:51Z","timestamp":1746077991000},"page":"1009-1025","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Maternal and fetal outcomes in subsequent pregnancies after peripartum cardiomyopathy: A systematic review and meta\u2010analysis"],"prefix":"10.1111","volume":"104","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0983-7590","authenticated-orcid":false,"given":"Rebecca","family":"Man","sequence":"first","affiliation":[{"name":"Department of Applied Health Sciences, School of Health Sciences, College of Medicine and Health University of Birmingham  Birmingham UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1725-0116","authenticated-orcid":false,"given":"Jack","family":"Le Vance","sequence":"additional","affiliation":[{"name":"Department of Applied Health Sciences, School of Health Sciences, College of Medicine and Health University of Birmingham  Birmingham UK"},{"name":"Birmingham Women's Hospital  Birmingham UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hafsa","family":"Abdullahi","sequence":"additional","affiliation":[{"name":"Epsom and St Helier University Hospitals  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5659-4889","authenticated-orcid":false,"given":"Clare","family":"Davenport","sequence":"additional","affiliation":[{"name":"Department of Applied Health Sciences, School of Health Sciences, College of Medicine and Health University of Birmingham  Birmingham UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mengshi","family":"Yuan","sequence":"additional","affiliation":[{"name":"Queen Elizabeth Hospital  Birmingham UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1820-5800","authenticated-orcid":false,"given":"Laura","family":"Ormesher","sequence":"additional","affiliation":[{"name":"Maternal &amp; Fetal Health Research Centre, Division of Developmental Biology and Medicine University of Manchester  Manchester UK"},{"name":"Saint Mary's Hospital Manchester University NHS Foundation Trust  Manchester UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4112-8257","authenticated-orcid":false,"given":"Sana","family":"Usman","sequence":"additional","affiliation":[{"name":"Queen Charlotte's and Chelsea Hospital  London UK"},{"name":"Department of Metabolism, Digestion and Reproduction, Institute of Reproductive Developmental Biology Imperial College London  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6309-3978","authenticated-orcid":false,"given":"James","family":"Castleman","sequence":"additional","affiliation":[{"name":"Birmingham Women's Hospital  Birmingham UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0150-8282","authenticated-orcid":false,"given":"Caroline","family":"Fox","sequence":"additional","affiliation":[{"name":"Birmingham Women's Hospital  Birmingham UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lucy","family":"Hudsmith","sequence":"additional","affiliation":[{"name":"Queen Elizabeth Hospital  Birmingham UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1247-429X","authenticated-orcid":false,"given":"R. 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