Conclusions

In this prospective comparative observational study, both treatment groups demonstrated early improvement in left ventricular function during follow-up. Patients who received adjunctive low-dose bromocriptine experienced a greater improvement in LVEF at one month. However, because of the nonrandomized study design, baseline differences between the groups, incomplete documentation of background medical therapy, and the relatively short follow-up period, this finding cannot be attributed solely to bromocriptine. Neonatal outcomes should also be interpreted with caution, as they may have been influenced by prematurity and differences in maternal disease severity at baseline. Future well-designed prospective studies with larger sample sizes, standardized contemporary heart failure management, comprehensive documentation of anticoagulation and lactation counseling, source-verified neonatal data, appropriate statistical adjustment for confounding factors, and longer follow-up are needed to better define the role of bromocriptine in the management of peripartum cardiomyopathy.