Arterial stiffness throughout pregnancy: Arteriograph device-specific reference ranges based on a low-risk population.

Autor:	Anness AR; Maternal and Fetal Medicine Unit, University Hospitals of Leicester NHS Trust, Leicester.; University of Leicester, Leicester., Nath M; Institute of Applied Health Sciences, University of Aberdeen, Aberdeen., Melhuish K; Maternal and Fetal Medicine Unit, University Hospitals of Leicester NHS Trust, Leicester., Osman MW; Maternal and Fetal Medicine Unit, University Hospitals of Leicester NHS Trust, Leicester., Webb D; Diabetes Research Centre., Robinson T; College of Life Sciences, University of Leicester.; University of Leicester, Leicester., Khalil A; St. George's University Hospital, University of London, London, UK., Mousa HA; Maternal and Fetal Medicine Unit, University Hospitals of Leicester NHS Trust, Leicester.
Jazyk:	angličtina
Zdroj:	Journal of hypertension [J Hypertens] 2022 May 01; Vol. 40 (5), pp. 870-877. Date of Electronic Publication: 2022 Feb 14.
DOI:	10.1097/HJH.0000000000003086
Abstrakt:	Objective: The maternal cardiovascular system undergoes significant adaptation during pregnancy. We aimed to examine the changes in arterial stiffness parameters during normal pregnancy and establish reference ranges for the general population. Methods: We performed a prospective cross-sectional observational study at the University Hospitals of Leicester. We included low-risk healthy pregnant women with singleton and viable pregnancies with no evidence of foetal abnormality or aneuploidy. Smokers, women with pre-existing or gestational hypertensive disorders and diabetes, booking BMI at least 30, on medication that could affect cardiac function and/or those who delivered before 37 completed weeks of gestation, and/or a neonate with birthweight less than 10th centile were excluded. Brachial (BrAIx) and aortic augmentation indices (AoAIx), and pulse wave velocity (PWV) were assessed using the Arteriograph. Data were analysed using a linear mixed model. Results: We analysed a total of 571 readings from 259 women across different gestational ages and present the 10th, 25th, 50th, 75th and 90th centiles for BrAIx, AoAIx and PWV from 12+0 to 42+0 weeks' gestation. All haemodynamic variables were significantly associated with maternal heart rate. BrAIx, AoAIx and PWV demonstrated significant change with gestation, with all reaching their lowest value in the second trimester. Conclusion: The current study presents reference ranges for BrAIx, AoAIx and PWV in low-risk singleton pregnancies. Further work is required to establish if women in whom measures of arterial stiffness lie above the 90th centile could be at increased risk of adverse pregnancy outcomes and to identify the optimum time for screening. (Copyright © 2022 Wolters Kluwer Health, Inc. All rights reserved.)
Databáze:	MEDLINE
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