Arterial stiffness, central hemodynamics and wave reflection in normal pregnancy and control nonpregnant women

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.

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.

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.

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.