P5.01 PRE-PREGNANCY TO EARLY PREGNANCY CHANGES IN MATERNAL CARDIOVASCULAR PHYSIOLOGY
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Maternal heart rate, blood pressure and cardiac output change as early as 5–6weeks in pregnancy. However, most of the longitudinal studies assessing maternal haemodynamic adaptation have used late first trimester measurements as ‘baseline’ against which changes in normal and complicated pregnancies have been compared. Moreover, the extent of changes in maternal arterial stiffness and central haemodynamics very early in pregnancy is not known.
Our aim was to assess pre-pregnancy to early pregnancy maternal cardiovascular adaptation including arterial stiffness.
Method: 44 women planning to conceive were prospectively recruited (22–40yrs). Cardiovascular assessments were performed pre-pregnancy and repeated very early in pregnancy (2–3 weeks after the first positive pregnancy test) including brachial and central blood pressures, augmentation index (AIx), aortic pulse wave velocity (aPWV) and cardiac output (CO).
Results: While heart rate (P=0.001) and cardiac output (P=0.005) increased significantly, both brachial and central blood pressure were significantly reduced (P<0.001) within 2–3 weeks of conception. AIx was also significantly reduced, even after adjustment for the change in HR (P=0.005) along with a reduction in peripheral vascular resistance (P=0.008). aPWV was unaltered, even after adjustment for MAP (P=0.6).
Conclusion: This is the first study to investigate changes in AIx and PWV very early in pregnancy. We have demonstrated profound changes in brachial and central blood pressures and AIx within 2–3 weeks of conception, with no change in aPWV. Furthermore, late first trimester data cannot be used as ‘baseline’ data in order to identify the extent of cardiovascular adaptation in pregnancy as has been hitherto assumed.
| Pre-pregnancy | Early pregnancy | P* | |
|---|---|---|---|
| HR (beats/min) | 69 ± 11 | 73 ± 10 | 0.001 |
| Brachial SBP (mm Hg) | 108 ± 9 | 103 ± 7 | <0.001 |
| Brachial DBP (mm Hg) | 70 ± 7 | 64 ± 5 | <0.001 |
| MAP (mm Hg) | 84 ± 8 | 77 ± 5 | <0.001 |
| CSBP (mm Hg) | 98 ± 9 | 91 ± 6 | <0.001 |
| CO (L/min) | 5.5 ± 1.0 | 5.9 ± 1.1 | 0.005 |
| SV (ml) | 76 ± 10 | 77 ± 14 | 0.6 |
| CI (L/min/m2) | 3.2 ± 0.6 | 3.5 ± 0.6 | 0.003 |
| PVR (dynes.s−1.cm−5) | 1253 ± 253 | 1074 ± 223 | 0.008 |
| Supine AIxa (%) | 20 ± 9 | 13 ± 9 | <0.001 |
| Supine AIxb (%) | 19 ± 10 | 13 ± 9 | 0.005 |
| aPWVa (m/sec) | 5.2 ± 0.6 | 5.0 ± 0.5 | 0.1 |
| aPWVc (m/sec) | 5.1 ± 0.5 | 5.2 ± 0.5 | 0.6 |
Data are means ± SD. a= unadjusted. b= heart rate adjusted. c=adjusted for Mean arterial pressure.
P<0.05 is statistically significant (Heart rate= HR, SBP= Systolic blood pressure, DBP= Diastolic blood pressure, MAP=Mean arterial pressure, CSBP= Central systolic blood pressure, CO=cardiac output, SV= stroke volume, CI= Cardiac Index, PVR= peripheral vascular resistance)
Pre-pregnancy to early pregnancy (2–3 weeks after positive pregnancy test) cardiovascular changes
Pre-pregnancy to early pregnancy changes in AIx (%)
Cite this article
TY - JOUR AU - A.A. Mahendru AU - C.C. Lees AU - T.R. Everett AU - I.B. Wilkinson AU - C.M. McEniery PY - 2011 DA - 2011/11/29 TI - P5.01 PRE-PREGNANCY TO EARLY PREGNANCY CHANGES IN MATERNAL CARDIOVASCULAR PHYSIOLOGY JO - Artery Research SP - 162 EP - 163 VL - 5 IS - 4 SN - 1876-4401 UR - https://doi.org/10.1016/j.artres.2011.10.058 DO - 10.1016/j.artres.2011.10.058 ID - Mahendru2011 ER -