Peripartum cardiomyopathy (PPCM) is a rare but potentially life-threatening form of heart failure (HF). Bromocriptine, a dopamine D2 agonist, has been used as an adjunctive treatment for PPCM with controversial benefits. A comprehensive literature search was conducted through June 2021. We included studies comparing the outcomes of PPCM with or without bromocriptine use. Pooled risk ratio (RR) with 95% confidence intervals (CI) and I² statistics were calculated. Composite major adverse outcomes were defined by a composite of death, need for advanced HF therapies, persistent New York Heart Association (NYHA) functional class III/V, or left ventricular ejection fraction (LVEF) ≤ 35% at 6-month follow-up. LVEF recovery was defined by improvement of LVEF to more than 50%. Eight studies (two randomized-controlled, six observational) involving 593 PPCM patients were included. Bromocriptine use was associated with significantly higher survival (91.6% vs. 83.9%, RR 1.11 p = 0.02). Baseline LVEF was not significantly different between the groups. LVEF at follow-up was significantly higher in the bromocriptine group (53.3% vs. 41.8%, p < 0.001). There was no significant association between bromocriptine use and lower composite major adverse outcomes (13.7% vs. 33.3%, RR 0.60 p = 0.54) or LVEF recovery (46.9% vs. 46.8%, RR 0.94 p = 0.74). In conclusion, the addition of bromocriptine to standard HF treatment in PPCM was associated with significantly higher survival and higher LVEF improvement. No association with lower composite adverse clinical outcomes or LVEF recovery was seen. The findings, although encouraging, warrant larger randomized-controlled studies.

围产期心肌病 (PPCM) 是一种罕见但可能危及生命的心力衰竭 (HF)。溴隐亭是一种多巴胺 D2 激动剂，已被用作 PPCM 的辅助治疗，但疗效存在争议。在 2021 年 6 月之前进行了全面的文献检索。我们纳入了比较使用或不使用溴隐亭的 PPCM 结局的研究。具有 95% 置信区间 (CI) 和I ^{2的合并风险比 (RR)}进行了统计。复合主要不良结局定义为死亡、需要高级 HF 治疗、持续性纽约心脏协会 (NYHA) 功能分级 III/V 或 6 个月随访时左心室射血分数 (LVEF) ≤ 35% . LVEF 恢复定义为 LVEF 改善至 50% 以上。共纳入 8 项研究（2 项随机对照，6 项观察性研究），涉及 593 名 PPCM 患者。溴隐亭的使用与显着更高的生存率相关（91.6% vs. 83.9%，RR 1.11 p  = 0.02）。基线 LVEF 在各组之间没有显着差异。溴隐亭组随访时的 LVEF 显着升高（53.3% vs. 41.8%，p < 0.001)。溴隐亭的使用与较低的复合主要不良结局（13.7% vs. 33.3%，RR 0.60 p  = 0.54）或 LVEF 恢复（46.9% vs. 46.8%，RR 0.94 p  = 0.74）之间没有显着关联。总之，在 PPCM 的标准 HF 治疗中添加溴隐亭与显着更高的存活率和更高的 LVEF 改善相关。未观察到与较低的复合不良临床结果或 LVEF 恢复相关。这些发现虽然令人鼓舞，但值得进行更大规模的随机对照研究。