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Central haemodynamics in normal pregnancy

a prospective longitudinal study

O’ Callaghan, Karen M.a,b; Hennessy, Áinea,b; Malvisi, Lucioa; Kiely, Maireada,b

doi: 10.1097/HJH.0000000000001768
ORIGINAL PAPERS: Pregnancy

Objective: To conduct a longitudinal evaluation of the central haemodynamic adaptations of normal pregnancy.

Methods: This was a prospective longitudinal study involving healthy, normotensive women who were having an uncomplicated, singleton pregnancy. Brachial and central SBP, DBP, mean arterial pressure (MAP), brachial and central pulse pressure (PP), aorta-to-brachial pulse pressure amplification (AMPA–B), heart rate (HR), augmentation index adjusted for HR (AIx75), carotid–femoral pulse wave velocity (cfPWV) and cardiac output (CO) were measured at a mean gestational age of 14, 24 and 36 weeks.

Results: One hundred women were followed prospectively throughout pregnancy. Brachial and central SBP, DBP and MAP decreased slightly in early gestation, followed by a significant increase in late gestation (P < 0.05). Brachial PP was lowest in the final trimester (P = 0.011) whereas central PP remained unchanged, resulting in a significant decrease in AMPA–B (P < 0.001). HR and AIx75 rose continuously throughout pregnancy (P < 0.001). A significant fall in cfPWV was observed mid-pregnancy, which remained significant after adjustment for MAP and HR (P < 0.05). CO rose mid-pregnancy, before returning to baseline values by week 36 of gestation (P < 0.05).

Conclusion: To our knowledge, this is the largest prospective study to evaluate several central haemodynamic parameters in normotensive pregnancies, including adjusted-AIx and the gold-standard cfPWV. These data are a necessary foundation for the establishment of pregnancy-specific reference values and provide reference data for future trial design.

aCork Centre for Vitamin D and Nutrition Research, School of Food and Nutritional Sciences

bIrish Centre for Fetal and Neonatal Translational Research (INFANT), University College Cork, Cork, Ireland

Correspondence to Professor Mairead Kiely, Cork Centre for Vitamin D and Nutrition Research, Room 127, Food Science Building, University College Cork, Western Road, Cork, Ireland, Tel:+353 214903394; e-mail: m.kiely@ucc.ie

Received 29 November, 2017

Revised 14 March, 2018

Accepted 2 April, 2018

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