Maternal hemodynamics at 11–13 weeks of gestation and preterm birth
Article first published online: 15 JUN 2012
Copyright © 2012 ISUOG. Published by John Wiley & Sons, Ltd.
Ultrasound in Obstetrics & Gynecology
Volume 40, Issue 1, pages 35–39, July 2012
How to Cite
Khalil, A., Elkhouli, M., Garcia-Mandujano, R., Chiriac, R. and Nicolaides, K. H. (2012), Maternal hemodynamics at 11–13 weeks of gestation and preterm birth. Ultrasound Obstet Gynecol, 40: 35–39. doi: 10.1002/uog.11154
- Issue published online: 29 JUN 2012
- Article first published online: 15 JUN 2012
- Accepted manuscript online: 14 MAY 2012 03:38AM EST
- Manuscript Accepted: 10 NOV 2011
- arterial stiffness;
- central systolic blood pressure;
- preterm birth;
- pulse wave velocity
Women who experience preterm birth (PTB) are at increased risk of cardiovascular morbidity and mortality in the subsequent decades. Individuals with cardiovascular disorders have increased central aortic systolic blood pressure (SBPAo) and arterial stiffness, assessed by pulse wave velocity (PWV) and augmentation index (AIx). The aim of this screening study was to evaluate SBPAo, PWV and AIx at 11–13 weeks' gestation in women who delivered preterm.
This was a prospective study in singleton pregnancies at 11 + 0 to 13 + 6 weeks' gestation. Maternal history and characteristics were recorded, and PWV, AIx and SBPAo were measured. We compared these parameters in women who had spontaneous (n = 244) or iatrogenic (n = 110) PTB before 37 weeks' gestation and before 34 weeks with those in women who had term delivery (n = 7489).
Compared with women who had term delivery, women who had iatrogenic PTB had significantly higher AIx (1.08 (interquartile range (IQR), 0.91–1.27) multiples of the median (MoM), vs. 1.00 (IQR, 0.86–1.16) MoM) and SBPAo (1.06 (IQR, 0.98–1.15) MoM vs. 1.00 (IQR, 0.93–1.07) MoM). However, there was no significant difference in AIx, PWV or SBPAo between those who had spontaneous PTB and those who had term delivery. These findings were similar for those who had PTB at < 34 and < 37 weeks' gestation.
Women who had iatrogenic PTB, but not those who had spontaneous PTB, have increased SBPAo and arterial stiffness that is apparent from as early as the first trimester of pregnancy. Copyright © 2012 ISUOG. Published by John Wiley & Sons, Ltd.