First trimester screening identifies maternal cardiac maladaptation at mid-gestation
This article is protected by copyright. All rights reserved..
BACKGROUND: First, a logistic regression model, based on maternal demographic characteristics and medical history and blood pressure at 11-13 weeks' gestation, can identify about 70% of women who develop future chronic hypertension (CH) in the three years following pregnancy, at screen positive rate of 10%. Second, at mid-gestation women who subsequently develop hypertensive disorders of pregnancy (HDP) have increased peripheral vascular resistance and mild cardiac functional and morphological alterations and these cardiovascular abnormalities persist for at least 2 years after delivery.
OBJECTIVE: To examine whether the use of the first-trimester risk for subsequent development of CH can help to identify women at high risk for cardiovascular maladaptation at mid-gestation.
METHODS: Prospective observational study in 3812 women with singleton pregnancies women attending for a routine hospital visit at 11+0 to 13+6 weeks' gestation and again at 19+1 to 23+3 weeks at King's College Hospital, London, UK between August 2019 and August 2020. The first-trimester visit included recording of maternal demographic characteristics and medical history and measurement of systolic and diastolic blood pressure. At mid-gestation detailed maternal cardiovascular assessment was carried out. The association of risk for development of CH, determined from first-trimester assessment, and cardiovascular indices at mid-gestation was examined.
RESULTS: Women who are at high-risk for development of future CH, compared to those at low-risk, had a higher incidence of hypertensive disorders of pregnancy (HDP). In addition, high-risk women, had reduced systolic and diastolic function at mid-gestation. Among women with HDP, those who were high-risk for future CH, compared to those at low-risk, also had worse cardiac function at mid-gestation.
CONCLUSION: Use of a model for first-trimester prediction of subsequent development of CH can identify women who show evidence of cardiac maladaptation at mid-gestation. Further studies are needed to clarify whether women who screen as high-risk for future CH, compared to those at low-risk, have reduced cardiac function beyond pregnancy. This article is protected by copyright. All rights reserved.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2024 |
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| Erschienen: |
2024 |
| Enthalten in: |
Zur Gesamtaufnahme - year:2024 |
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| Enthalten in: |
Ultrasound in obstetrics & gynecology : the official journal of the International Society of Ultrasound in Obstetrics and Gynecology - (2024) vom: 13. März |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Charakida, M [VerfasserIn] |
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| Links: |
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| Themen: |
Cardiovascular indices |
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| Anmerkungen: |
Date Revised 13.03.2024 published: Print-Electronic Citation Status Publisher |
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| doi: |
10.1002/uog.27640 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM369668782 |
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| 245 | 1 | 0 | |a First trimester screening identifies maternal cardiac maladaptation at mid-gestation |
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| 520 | |a This article is protected by copyright. All rights reserved. | ||
| 520 | |a BACKGROUND: First, a logistic regression model, based on maternal demographic characteristics and medical history and blood pressure at 11-13 weeks' gestation, can identify about 70% of women who develop future chronic hypertension (CH) in the three years following pregnancy, at screen positive rate of 10%. Second, at mid-gestation women who subsequently develop hypertensive disorders of pregnancy (HDP) have increased peripheral vascular resistance and mild cardiac functional and morphological alterations and these cardiovascular abnormalities persist for at least 2 years after delivery | ||
| 520 | |a OBJECTIVE: To examine whether the use of the first-trimester risk for subsequent development of CH can help to identify women at high risk for cardiovascular maladaptation at mid-gestation | ||
| 520 | |a METHODS: Prospective observational study in 3812 women with singleton pregnancies women attending for a routine hospital visit at 11+0 to 13+6 weeks' gestation and again at 19+1 to 23+3 weeks at King's College Hospital, London, UK between August 2019 and August 2020. The first-trimester visit included recording of maternal demographic characteristics and medical history and measurement of systolic and diastolic blood pressure. At mid-gestation detailed maternal cardiovascular assessment was carried out. The association of risk for development of CH, determined from first-trimester assessment, and cardiovascular indices at mid-gestation was examined | ||
| 520 | |a RESULTS: Women who are at high-risk for development of future CH, compared to those at low-risk, had a higher incidence of hypertensive disorders of pregnancy (HDP). In addition, high-risk women, had reduced systolic and diastolic function at mid-gestation. Among women with HDP, those who were high-risk for future CH, compared to those at low-risk, also had worse cardiac function at mid-gestation | ||
| 520 | |a CONCLUSION: Use of a model for first-trimester prediction of subsequent development of CH can identify women who show evidence of cardiac maladaptation at mid-gestation. Further studies are needed to clarify whether women who screen as high-risk for future CH, compared to those at low-risk, have reduced cardiac function beyond pregnancy. This article is protected by copyright. All rights reserved | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Hypertension | |
| 650 | 4 | |a cardiovascular indices | |
| 650 | 4 | |a model | |
| 650 | 4 | |a pregnancy | |
| 650 | 4 | |a risk factors | |
| 700 | 1 | |a Gibbone, E |e verfasserin |4 aut | |
| 700 | 1 | |a Huluta, I |e verfasserin |4 aut | |
| 700 | 1 | |a Syngelaki, A |e verfasserin |4 aut | |
| 700 | 1 | |a Wright, A |e verfasserin |4 aut | |
| 700 | 1 | |a Nicolaides, K H |e verfasserin |4 aut | |
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