Association between arterial stiffness and wave reflection with subsequent development of placental-mediated diseases during pregnancy
| Autor: | Asma Khalil, David R. Webb, Eamonn Breslin, Mintu Nath, Mohamed Waseem Osman, Thompson G. Robinson, Hatem A Mousa |
|---|---|
| Rok vydání: | 2018 |
| Předmět: |
medicine.medical_specialty
Physiology Pulse Wave Analysis 030204 cardiovascular system & hematology Preeclampsia 03 medical and health sciences Vascular Stiffness 0302 clinical medicine Pre-Eclampsia Pregnancy Internal Medicine medicine Humans Pregnancy Trimesters Pulse wave velocity Fetal Growth Retardation 030219 obstetrics & reproductive medicine Placental abruption Obstetrics business.industry Infant Newborn Pregnancy Outcome medicine.disease Strictly standardized mean difference Infant Small for Gestational Age Arterial stiffness Small for gestational age Female Cardiology and Cardiovascular Medicine business |
| Zdroj: | Journal of Hypertension. 36:1005-1014 |
| ISSN: | 0263-6352 |
| DOI: | 10.1097/hjh.0000000000001664 |
| Popis: | Objective: We present a comprehensive systematic review of published literature to examine, whether arterial stiffness and wave reflection measurements during pregnancy differed between healthy patients and patients with placental-mediated diseases including preeclampsia (PET), small for gestational age (SGA), fetal death, and placental abruption, and a quantitative assessment of the findings using the meta-analysis approach. Methods: We searched Medline, Embase, and The Cochrane Library for studies of arterial stiffness in pregnancy, analyzed pregnancy outcomes and conducted the meta-analysis of data evaluated by trimesters of pregnancy. Hemodynamic parameters evaluated included: pulse wave velocity (PWV), augmentation index (AIx), and augmentation index-75 (AIx-75). Results: We screened 2806 citations, reviewed 36 studies and included nine (n = 15 923) studies for further quantitative assessment. Compared with healthy pregnancy, measures of arterial stiffness and wave reflection were consistently increased among pregnant women who subsequently developed PET during all trimesters. In the first trimester, mean AIx-75 (%) in the PET group was significantly higher with estimated standardized mean difference (SMD) of 0.90 [95% confidence intervals (95% CI) 0.07–1.73; P = 0.034]. In the second trimester, the PET group had significantly higher PWV (m/s) with estimated SMD of 1.26 (95% CI 0.22–2.30; P = 0.018). Concerning the SGA group, mean AIx (%) was greater during the second trimester only: 65.5 (SD 15.6) vs. 57.0 (11.2), P Conclusion: There is significant increase in arterial stiffness and wave reflection parameters among pregnant women who subsequently developed PET and SGA fetuses. Larger studies with consistent methodological designs are required to evaluate the role and usefulness of arterial stiffness and wave reflection measurements as a screening tool for placental-mediated diseases during pregnancy. |
| Databáze: | OpenAIRE |
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