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Morphofunctional cardiac changes in singleton and twin pregnancies: a longitudinal cohort study.
Takeshi Umazume1, Takahiro Yamada2, Itsuko Furuta2
1Department of Obstetrics and Gynecology, Hokkaido University Graduate School of Medicine, N15W7, Kita-ku, Sapporo, 060-8638, Japan. takeuma@med.hokudai.ac.jp.
BMC Pregnancy and Childbirth
|December 3, 2020
Summary
Twin pregnancies show increased cardiac load and higher brain natriuretic peptide (BNP) levels compared to singleton pregnancies, especially postpartum. BNP levels correlate with cardiac changes, suggesting potential impacts on diastolic function in singleton pregnancies post-childbirth.
Area of Science:
- Cardiology
- Maternal-Fetal Medicine
- Biomarkers
Background:
- Pregnancy significantly alters cardiovascular function.
- Distinguishing physiological changes in singleton versus multiple gestations is crucial for maternal health monitoring.
Purpose of the Study:
- To compare echocardiographic parameters and cardiac biomarkers between women with singleton and twin pregnancies.
- To investigate the relationship between cardiac biomarkers and echocardiographic findings during pregnancy and postpartum.
Main Methods:
- A longitudinal cohort study involving 44 women with singleton and 22 women with twin pregnancies.
- Prospective collection of echocardiographic data and blood cardiac markers.
- Mixed-effect models were used to analyze changes in parameters over time.
Main Results:
- Women with twin pregnancies exhibited higher left atrial volume index and brain natriuretic peptide (BNP) levels in the third trimester and postpartum.
- Twin pregnancies were associated with smaller second-trimester inferior vena cava diameters and higher third-trimester creatinine levels.
- BNP positively correlated with left atrial volume index and early diastolic transmitral to mitral annular velocity (E/e').
Conclusions:
- Intravascular cardiac load peaks within one week postpartum and is greater in twin pregnancies.
- BNP/N-terminal precursor protein BNP (NT-proBNP) levels correlate with left atrial volume index and E/e'.
- In singleton pregnancies, postpartum BNP may contribute to improved diastolic function at one month postpartum.
