Maternal cardiovascular function at 35-37 weeks' gestation: relation to maternal characteristics

Area of Science:

• Obstetrics and Gynecology
• Cardiovascular Physiology
• Maternal-Fetal Medicine

Background:

• Maternal cardiovascular parameters change throughout pregnancy.
• Understanding factors influencing these changes is vital for monitoring maternal and fetal well-being.
• Accurate assessment is critical for conditions like pre-eclampsia.

Purpose of the Study:

• To investigate the impact of maternal characteristics and medical history on cardiovascular parameters.
• To identify significant predictors of maternal cardiovascular metrics in late gestation.
• To inform adjustments for improved screening protocols.

Main Methods:

• A cohort of 3013 pregnant women at 35-37 weeks' gestation was studied.
• Maternal characteristics, medical history, and cardiovascular parameters (including uterine artery pulsatility index and mean arterial pressure) were recorded.
• Multivariable regression analysis identified significant predictors of cardiovascular outcomes.

Main Results:

• Gestational age, maternal age, weight, weight gain, height, race, smoking, assisted conception, and prior neonatal birth weight influenced cardiac output, cardiac power, and stroke volume.
• Chronic hypertension, diabetes mellitus, and prior pre-eclampsia were significant predictors for total peripheral resistance and heart rate.
• Maternal weight, race, family history of pre-eclampsia, chronic hypertension, and diabetes mellitus affected mean arterial pressure.

Conclusions:

• Maternal characteristics and medical history significantly impact cardiovascular parameters in late pregnancy.
• These parameters require adjustment based on identified predictors for accurate interpretation.
• Adjusted parameters are recommended for combined screening protocols, particularly for pre-eclampsia detection.