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Third-Trimester Cardiovascular Function and Risk of Hypertensive Disorders of Pregnancy
Frederikke Lihme1, Saima Basit1, Lisa G Persson1,2
1Department of Epidemiology Research Statens Serum Institut Copenhagen Denmark.
Journal of the American Heart Association
|October 11, 2024
Summary
Low cardiac output (CO) is linked to preeclampsia risk in pregnant women, especially before 37 weeks. Monitoring cardiovascular function in the third trimester may help identify women without fetal growth restriction (FGR) at risk.
Area of Science:
- Cardiovascular physiology in pregnancy
- Hypertensive disorders of pregnancy
Background:
- The association between cardiovascular dysfunction and preeclampsia in women without fetal growth restriction (FGR) remains unclear.
- Preeclampsia is a serious condition affecting pregnant women, characterized by high blood pressure.
Purpose of the Study:
- To investigate the association between third-trimester cardiac output (CO) and systemic vascular resistance (SVR) and the risk of hypertensive disorders of pregnancy.
- To determine if cardiovascular dysfunction predicts preeclampsia in women with and without FGR.
Main Methods:
- A case-cohort study involving 906 pregnant women in Denmark.
- Repeated third-trimester cardiovascular function assessments using the Ultrasound Cardiac Output Monitor 1A.
- Cox regression analysis to compare rates of hypertensive disorders based on CO and SVR levels, stratified by FGR status.
Main Results:
- Low CO was strongly associated with preeclampsia before 37 weeks, in both women with and without FGR.
- A third-trimester drop in CO was associated with preeclampsia in women without FGR.
- High SVR was strongly associated with increased rates of all hypertensive disorders of pregnancy.
Conclusions:
- Low cardiac output is a significant risk factor for preeclampsia, particularly in early preterm pregnancies.
- Monitoring third-trimester cardiovascular function may aid in identifying women without FGR who require closer preeclampsia surveillance.
- Further research is needed to confirm these findings in diverse populations.
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