Prepregnancy CV function and risk for preeclampsia, fetal growth restriction

  • Foo FL & al.
  • Hypertension
  • 1 Aug 2018

  • curated by Elisabeth Aron, MD, MPH, FACOG
  • Clinical Essentials
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Takeaway

  • Women with cardiovascular (CV) hemodynamic dysfunction before pregnancy may be at risk for preeclampsia and/or fetal growth restriction (FGR).

Why this matters

  • CV hemodynamic dysfunction may be responsible for the development of preeclampsia and FGR.
  • Identifying women at risk for preeclampsia/FGR may help to prevent some adverse pregnancy outcomes.

Key results

  • 6.8% of cohort had preeclampsia/FGR.
  • Preconception cardiac output (4.9 vs 5.8 L/minute; P=.002), cardiac index (2.9 vs 3.3 L/minute/m2; P=.031), and stroke volume (73.9 vs 82.2 mL; P=.047) were lower in women with preeclampsia/FGR.
  • Total peripheral resistance (1396.4 vs 1156.1 dynes·second·cm−5; P<.001 and mean arterial pressure vs mmhg p=".04) were" higher in women with preeclampsia>

Study design

  • Prospective cohort study of healthy women intending to conceive (n=530).
  • CV hemodynamic assessments were performed and women followed up until conception (n=356).
  • Singleton pregnancies without complications received multiple hemodynamic assessments during pregnancy (n=218).
  • Funding: National Institute for Health Research Imperial BRC; Imperial College Healthcare Charity.

Limitations

  • Small number of patients with preeclampsia/FGR.
  • Selection bias is possible.

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