TY - JOUR
T1 - Peripheral maternal haemodynamics across pregnancy in hypertensive disorders of pregnancy
AU - Verburg, Petra E.
AU - Roberts, Claire T.
AU - McBean, Emma
AU - Mulder, Mylene E.
AU - Leemaqz, Shalem
AU - Erwich, Jan Jaap H.M.
AU - Dekker, Gus A.
N1 - Funding Information:
The Screening Tests to predict poor Outcomes of Pregnancy (STOP) study was funded by the University of Adelaide. CTR is supported by a Lloyd Cox Professorial Research Fellowship from the University of Adelaide. The authors have received no other funding from an external source.
Publisher Copyright:
© 2019 International Society for the Study of Hypertension in Pregnancy
PY - 2019/4
Y1 - 2019/4
N2 - Objectives: Evaluating maternal haemodynamics across pregnancy in uncomplicated pregnancies and those complicated by hypertensive disorders of pregnancy (HDP). Study design: Prospective cohort study from 2015 to 2018 of healthy, nulliparous, singleton-bearing women. Maternal haemodynamics assessed by Uscom BP+ at 9–16 and 32–36 weeks’ gestation in pregnancies complicated by HDP [preeclampsia with severe (sPE n = 12) and without severe clinical features (nsPE n = 49), gestational hypertension (GH n = 25), transient gestational hypertension (TGH n = 33)] were compared to uncomplicated pregnancies (n = 286) using mixed-effects linear modelling. Main outcome measures: Maternal haemodynamic adaptation in uncomplicated pregnancies and those complicated by HDP. Results: Between the two measurements, haemodynamic adaptation in women with sPE and nsPE was significantly different compared to those with uncomplicated pregnancies. An additional increase was observed for peripheral systolic blood pressure [SBP; 14.3 mmHg, 8.6–20.1 (sPE)], peripheral diastolic blood pressure [DBP; 7.7 mmHg, 3.3–12.1 (sPE); 2.6 mmHg, 3.3–12.1 (nsPE)] peripheral mean arterial pressure [MAP; 10.6 mmHg, 5.8–15.5 (sPE); 3.4 mmHg, 0.8–6.0 (nsPE)], peripheral pulse pressure [PP; 6.6 mmHg, 2.1–11.1 (sPE)], central SBP [15.8 mmHg, 10.4–21.2 (sPE); 2.9 mmHg, 0.1–5.8 (nsPE)], central DBP [8.3 mmHg, 3.9–12.6 (sPE); 2.5 mmHg, 0.2–4.8 (nsPE), central MAP [10.8 mmHg, 6.4–15.2 (sPE); 2.6 mmHg, 0.3–5.0 (nsPE)] and central PP [7.6 mmHg, 3.9–11.3 (sPE)]. Augmentation index (AIx) decreased less (15.5%, 6.3–24.6 (sPE); 9.0%, 4.2–13.6 (nsPE)] compared to uncomplicated pregnancies. Haemodynamic adaptation across pregnancy in women with GH and TGH was not different from those with uncomplicated pregnancies. Conclusion: Women who develop preeclampsia show an altered, while those who develop GH or TGH demonstrate a comparable haemodynamic adaptation compared to uncomplicated pregnancies. TGH is not a benign condition.
AB - Objectives: Evaluating maternal haemodynamics across pregnancy in uncomplicated pregnancies and those complicated by hypertensive disorders of pregnancy (HDP). Study design: Prospective cohort study from 2015 to 2018 of healthy, nulliparous, singleton-bearing women. Maternal haemodynamics assessed by Uscom BP+ at 9–16 and 32–36 weeks’ gestation in pregnancies complicated by HDP [preeclampsia with severe (sPE n = 12) and without severe clinical features (nsPE n = 49), gestational hypertension (GH n = 25), transient gestational hypertension (TGH n = 33)] were compared to uncomplicated pregnancies (n = 286) using mixed-effects linear modelling. Main outcome measures: Maternal haemodynamic adaptation in uncomplicated pregnancies and those complicated by HDP. Results: Between the two measurements, haemodynamic adaptation in women with sPE and nsPE was significantly different compared to those with uncomplicated pregnancies. An additional increase was observed for peripheral systolic blood pressure [SBP; 14.3 mmHg, 8.6–20.1 (sPE)], peripheral diastolic blood pressure [DBP; 7.7 mmHg, 3.3–12.1 (sPE); 2.6 mmHg, 3.3–12.1 (nsPE)] peripheral mean arterial pressure [MAP; 10.6 mmHg, 5.8–15.5 (sPE); 3.4 mmHg, 0.8–6.0 (nsPE)], peripheral pulse pressure [PP; 6.6 mmHg, 2.1–11.1 (sPE)], central SBP [15.8 mmHg, 10.4–21.2 (sPE); 2.9 mmHg, 0.1–5.8 (nsPE)], central DBP [8.3 mmHg, 3.9–12.6 (sPE); 2.5 mmHg, 0.2–4.8 (nsPE), central MAP [10.8 mmHg, 6.4–15.2 (sPE); 2.6 mmHg, 0.3–5.0 (nsPE)] and central PP [7.6 mmHg, 3.9–11.3 (sPE)]. Augmentation index (AIx) decreased less (15.5%, 6.3–24.6 (sPE); 9.0%, 4.2–13.6 (nsPE)] compared to uncomplicated pregnancies. Haemodynamic adaptation across pregnancy in women with GH and TGH was not different from those with uncomplicated pregnancies. Conclusion: Women who develop preeclampsia show an altered, while those who develop GH or TGH demonstrate a comparable haemodynamic adaptation compared to uncomplicated pregnancies. TGH is not a benign condition.
KW - Augmentation index
KW - Blood pressure
KW - Hypertensive disorders of pregnancy
KW - Maternal haemodynamics
UR - http://www.scopus.com/inward/record.url?scp=85063096610&partnerID=8YFLogxK
U2 - 10.1016/j.preghy.2019.02.006
DO - 10.1016/j.preghy.2019.02.006
M3 - Article
C2 - 31056165
AN - SCOPUS:85063096610
SN - 2210-7789
VL - 16
SP - 89
EP - 96
JO - Pregnancy Hypertension
JF - Pregnancy Hypertension
ER -