Change in maternal cardiac output from pre-conception to mid-pregnancy is associated with birth weight in healthy pregnancies
File(s)Birthweightstudy for UOG lin01112016 ccl 031116.doc (426.5 KB)
Accepted version
Author(s)
Type
Journal Article
Abstract
OBJECTIVE: Birth weight (BW) is thought to be determined by maternal health, and genetic, nutritional and placental factors; the latter being influenced by anatomical development and perfusion. Maternal cardiovascular changes contribute to uteroplacental perfusion, however they have not been investigated in relation to fetal growth/BW. Our aim was to explore the relationship between maternal cardiovascular adaptation, fetal growth and BW in healthy pregnancies. METHODS: This was a longitudinal prospective study of women planning to conceive a pregnancy. Maternal cardiac output (CO), cardiac index (CI), pulse-wave velocity, aortic augmentation index (AIx), central blood pressure and peripheral vascular resistance (PVR) were assessed prior to pregnancy and at 6, 23 and 33 weeks' gestation. Fetal growth was assessed by serial ultrasound measurements of biometry. RESULTS: In total, 143 women volunteered to participate and were eligible for study inclusion. One hundred and one women conceived within 18 months and there were 64 live births with normal pregnancy outcome. There were positive correlations between BW and the prepregnancy-to-second trimester changes in CO (ρ = 0.4, P = 0.004), CI (ρ = 0.3, P = 0.02) and PVR (ρ = 0.3, P = 0.02). There were significant associations between third-trimester estimated fetal weight gain and the prepregnancy-to-second trimester increase in CO (Δ, 0.8 ± 1.2 L/min; ρ = 0.3, P = 0.02) and CI (Δ, 0.4 ± 0.6 L/min/m(2) ; ρ = 0.3, P = 0.04) and reduction in AIx (Δ, -10 ± 9%; ρ = -0.3, P = 0.04). CONCLUSIONS: In healthy pregnancy, third-trimester fetal growth and BW are associated with incremental changes in maternal CO in early pregnancy. It is plausible that this association is causative, as changes predate third-trimester fetal growth and eventual BW.
Date Issued
2017-01-05
Date Acceptance
2016-11-14
ISSN
1469-0705
Publisher
Wiley
Start Page
78
End Page
84
Journal / Book Title
Ultrasound in Obstetrics & Gynecology
Volume
49
Copyright Statement
© 2016 Wiley. This is the accepted version of the following article: 'Change in maternal cardiac output from pre-conception to mid-pregnancy is associated with birth weight in healthy pregnancies', which has been published in final form at http://dx.doi.org/10.1002/uog.17368
Identifier
http://www.ncbi.nlm.nih.gov/pubmed/27859800
Subjects
Science & Technology
Technology
Life Sciences & Biomedicine
Acoustics
Obstetrics & Gynecology
Radiology, Nuclear Medicine & Medical Imaging
birth weight
cardiac output
hemodynamics
pregnancy
vascular resistance
INTRAUTERINE GROWTH RESTRICTION
PULMONARY BLOOD-FLOW
PULSE-WAVE ANALYSIS
FETAL-GROWTH
CARDIOVASCULAR CHANGES
REBREATHING TECHNIQUE
ARTERIAL STIFFNESS
HEART-DISEASE
REPRODUCIBILITY
ACCURACY
Obstetrics & Reproductive Medicine
1114 Paediatrics And Reproductive Medicine
Publication Status
Published
Coverage Spatial
England