Abstract
Objectives
Pregnancy is accompanied by different physiological adaptations in the cardiovascular
system. However, information on central blood pressures, wave reflection, arterial
stiffness in uncomplicated pregnancy compared with nonpregnant women is limited.
Study design
Forty-six women (mean age 28 years) in the third trimester of pregnancy and 45 healthy
age- and height-matched controls were evaluated. Arterial stiffness, central hemodynamics
and wave reflection was assessed with the use of digital volume pulse analysis and
pulse wave analysis.
Results
In comparison with nonpregnant participants, pregnant women had significantly lower
mean (p = 0.04) and central systolic (p = 0.02) blood pressure, central pulse pressure (p = 0.02), augmentation index (p = 0.02) and augmentation pressure (p = 0.002), whereas their pulse pressure amplification was significantly higher (p = 0.001). Similarly, arterial stiffness index was higher in pregnant women than in healthy
nonpregnant controls (p = 0.006). This index was correlated significantly with central augmentation index and
augmentation pressure (r = 0.5, p = 0.0005 and r = 0.52, p = 0.0002, respectively) but only in nonpregnant women.
Conclusions
Healthy pregnancy is associated with increased pulse pressure amplification as well
as diminished wave reflection, which results in lower central augmentation index and
augmentation pressure. Women in the third trimester of pregnancy have slightly higher
arterial stiffness in comparison with healthy nonpregnant, age- and height-matched
controls. The increased value of measures of arterial stiffness might be secondary
to a known physiological increase of cardiac output and the amount of circulating
blood.
Keywords
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to European Journal of Obstetrics and Gynecology and Reproductive BiologyAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- Serial assessment of the cardiovascular system in normal pregnancy.Circulation. 1997; 95: 2407-2415
- Pregnancy and the cardiovascular system.Int J Cardiol. 2005; 98: 179-189
- Central hemodynamics of hypertensive disorders in pregnancy.Am J Hypertens. 2004; 17: 941-946
- Maternal arterial stiffness in pregnancies affected by preeclampsia.Am J Physiol Heart Circ Physiol. 2009; 297: H759-H764
- Contour analysis of the photoplethysmographic pulse measured at the finger.J Hypertens. 2006; 24: 1449-1456
- Pulse wave analysis and pulse wave velocity: a critical review of their strengths and weaknesses.J Hypertens. 2003; 21: 463-472
- Clinical measurement of arterial stiffness obtained from noninvasive pressure waveforms.Am J Hypertens. 2005; 18: 3-10
- Determination of age-related increases in large artery stiffness by digital pulse contour analysis.Clin Sci. 2002; 103: 371-377
- Aortic stiffness is an independent predictor of all-cause and cardiovascular mortality in hypertensive patients.Hypertension. 2001; 37: 1236-1241
- Augmentation index is associated with cardiovascular risk.J Hypertens. 2002; 20: 2407-2414
- Peripheral arterial pulse wave analysis in women with pre-eclampsia and gestational hypertension.BJOG. 2005; 112: 1475-1478
- Arterial stiffness in preeclamptic and chronic hypertensive pregnancies.Eur J Obstet Gynecol Reprod Biol. 2006; 128: 180-186
- Pulse wave reflection in currently and previously preeclamptic women.Hypertens Pregnancy. 2005; 24: 171-180
- Methods of assessment of the arterial pulse wave in normal human pregnancy.Am J Obst Gynecol. 2004; 190: 472-476
- Maternal wave reflections and arterial stiffness in normal pregnancy as assessed by applanation tonometry.Hypertension. 2008; 51: 1047-1051
- Comparison of simultaneously recorded central and peripheral arterial pressure pulses during rest, exercise and tilted position in man.Circ Res. 1955; 3: 623-632
- Central pulse pressure and mortality in end-stage renal disease.Hypertension. 2002; 39: 735-738
- Pulse pressure amplification and risk of cardiovascular disease.Am J Hypertens. 2008; 21: 388-392
- Pulmonary vascular disease and pregnancy: current controversies, management strategies, and perspectives.Eur Heart J. 2000; 21: 104-115
- Expert consensus document on management of cardiovascular diseases during pregnancy.Eur Heart J. 2003; 24: 761-781
- The influence of heart rate on augmentation index and central arterial pressure in humans.J Physiol. 2000; 15: 263-270
- Heart rate dependency of pulse pressure amplification and arterial stiffness.Am J Hypertens. 2002; 15: 24-30
- Arterial stiffness and fetal growth in normotensive pregnancy.Am J Hypertens. 2005; 18: 337-341
- Birthweight and arterial stiffness and blood pressure in adulthood—results from the Amsterdam Growth and Health Longitudinal Study.Int J Epidemiol. 2004; 33: 154-161
- Profound impact of uncomplicated pregnancy on diastolic, but not systolic pulse contour of aortic pressure.J Hypertens. 2006; 24: 1641-1648
Article info
Publication history
Published online: June 27, 2011
Accepted:
June 9,
2011
Received in revised form:
May 13,
2011
Received:
January 27,
2011
Identification
Copyright
© 2011 Elsevier Ireland Ltd. Published by Elsevier Inc. All rights reserved.
