A longitudinal study of the maternal cardiovascular adaptation to spontaneous and assisted conception pregnancies

To determine the sequence and extent of maternal cardiovascular adaptation in an integrated way in spontaneous and assisted conception pregnancies.

Cardiovascular assessments were performed pre-pregnancy, during pregnancy and 6 weeks post delivery in women with normal spontaneously conceived singleton pregnancies (n = 13); singleton IVF pregnancies (n = 5); singleton OD pregnancies (n = 4); and multiple pregnancies (n = 6).

The OD singleton pregnancies had a significantly higher diastolic and mean blood pressure (BP) than the normal singleton pregnancies at 10 weeks gestation (p = 0.010 and 0.008, respectively), and the multiple pregnancy group had a higher systolic and mean BP at 16 weeks gestation than the IVF singleton pregnancy group (p = 0.045 and 0.033, respectively). The multiple pregnancy group had higher heart rate (HR) at 16 weeks gestation (p = 0.010), higher fractional shortening (FS) at 16 weeks gestation (p = 0.006), and higher left ventricular (LV) mass at 26 weeks gestation (p = 0.049) than the IVF singleton pregnancy group. The rate of change of LV mass was correlated to the rate of change of the blood pressure (r = 0.725, p = 0.005 for mean BP) and inversely correlated to the rate of change of fractional shortening (r = 0.767, and p = 0.002).

Ovum donation pregnancies are associated with higher BP in early pregnancy, whilst multiple pregnancies are associated with higher BP, FS and LV mass in later pregnancy.