Blood Pressure Variation Throughout Pregnancy According to Early Gestational BMI: A Brazilian Cohort

Rebelo, Fernanda; Farias, Dayana Rodrigues; Mendes, Roberta Hack; Schlüssel, Michael Maia; Kac, Gilberto

doi:10.5935/abc.20150007

Cited by 30 publications

(32 citation statements)

References 23 publications

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“…significant decrease was observed in the mean of SBP, DBP and MAP from first trimester to second trimester of pregnancy. Study results are in line with the reports of Rebelo F. et al They reported a decrease in SBP and DBP from first to the second trimester[19]. The possible explanation for the drop in blood pressure in the second trimester of pregnancy is due to cardiovascular adaptations including increased cardiac output, decreased vascular resistance and other metabolic changes[20].…”

supporting

confidence: 91%

Relationship between Mean Arterial Pressure, Uric Acid and Calcium with Xanthine Oxidase Activity and Fetal Outcome in Normotensive and Preeclampsia in a Nested Study

Gadde¹,

Doddaiah²,

Rangappa³

2018

OJOG

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Preeclampsia is a pregnancy complication; early identification with increased risk is one of the key goals in obstetrics. In a nested case control study, serum uric acid and calcium measured in first and second trimesters of pregnancy were correlated with Xanthine oxidase (XO) activity, mean arterial pressure (MAP) and fetal birth weight. The mean ± SD of uric acid (2.01 ± 0.85, 4.8 ± 1.93), calcium (10.88 ± 1.97, 9.72 ± 2.04), MAP (84.32 ± 6.71, 78.40 ± 8.53) and XO activity (11.96 ± 1.91, 14.05 ± 3.09) of the study group (n=86) were observed in the first and second trimesters respectively. First trimester normotensive group (n=79) and preeclampsia cases (n = 7), showed a mean ± SD of uric acid (1.93 ± 0.80, 2.9 ± 0.88), Calcium (10.92 ± 1.9, 10.6 ± 1.72), MAP (84.19 ± 6.75, 85.71 ± 6.58) XO activity (11.82 ± 1.83, 13.57 ± 2.21). In the second trimester, normotensive group and preeclampsia cases showed a mean ± SD uric acid (4.6 ± 1.75, 7.3 ± 2.19), Calcium (9.4 ± 1.85, 12.9 ± 1.04), MAP (76.41 ± 5.41, 100.95 ± 2.52) and XO activity (13.37 ± 1.93, 21.70 ± 3.50). Statistical analysis revealed a non-significant positive correlation in first trimester between uric acid and MAP (r = +0.116, p = 0.288), negative correlations between uric acid and fetal birth weight (r = −0.118, 0.279) and between calcium and MAP (r = −0.288, p = 0.007). In the second trimester, significant positive correlations were observed between uric acid (r = +0.246, p = 0.022), calcium (r = +0.326, p = 0.007) with MAP along with a significant negative correlation between uric acid (r = −0.641, p = 0.000), calcium (r = −0.316, p = 0.003), Proteinuria (r = −0.514, p = 0.000) with fetal birth weight. The screening of first and second trimesters XO activity, uric acid, calcium and MAP during pregnancy is beneficial in identifying women likely to develop

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supporting

confidence: 91%

Relationship between Mean Arterial Pressure, Uric Acid and Calcium with Xanthine Oxidase Activity and Fetal Outcome in Normotensive and Preeclampsia in a Nested Study

Gadde¹,

Doddaiah²,

Rangappa³

2018

OJOG

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“…The observation that CMV positivity is significantly associated with low systolic blood pressure contrasts with previous findings which have shown increasing systolic blood pressure with CMV positivity [36,37]. It is worth noting that the previous studies were carried out in non-pregnant adults, hence discrepancy in findings could be due to the well documented effects of pregnancy on fluctuations in blood pressure [38,39] masking the effects of CMV infection.…”

Section: Discussioncontrasting

confidence: 57%

Genetic variation in toll like Receptors 2, 7, 9 and interleukin-6 is associated with Cytomegalovirus infection in late pregnancy

Mhandire

Magadze

et al. 2020

Preprint

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Background: Maternal cytomegalovirus (CMV) infection and/or reactivation in pregnancy is associated with a myriad of adverse infant outcomes. However, the role of host genetic polymorphisms in modulating maternal CMV status is inconclusive. This study investigated the possible association of single nucleotide polymorphisms in toll like receptor (TLR) and cytokine genes with maternal plasma CMV DNA status in black Zimbabweans. Methods: In a cross-sectional study, 110 women in late gestation who included 36 CMV infected cases and 74 CMV uninfected, age and HIV status matched controls were enrolled. Twenty single nucleotide polymorphisms in 10 genes which code for proteins involved in immunity against CMV were genotyped using Iplex GOLD SNP genotyping protocol on the Agena MassARRAY® system. Statistical analyses were performed using Stata SE and the ‘Genetics’ and ‘SNPassoc’ packages of the statistical package R. Results: The TLR7 rs179008A>T (p<0.001) polymorphism was associated while the TLR9 rs352139T>C (p=0.049) polymorphism was on the borderline for association with CMV positive (CMV+) status. In contrast, the interleukin ( IL)-6 rs10499563T>C (p<0.001) and TLR2 rs1816702C>T (p=0.001) polymorphisms were associated with CMV negative (CMV-) status. Furthermore, allele frequencies of SNPs in TLR2, TLR4, TLR9, TLR7 , IL - 6 , IL-10 , IL-28B , IL-1A and interferon AR1 ( IFNAR1 ) genes are being reported here for the first time in a Zimbabwean population. The allele frequencies in the Zimbabwean population re generally comparable to other African populations but different when compared to European and Asian populations. Conclusions: Toll like receptor and interleukin genetic polymorphisms influence CMV status in late gestation among black Zimbabweans. This is attributable to possible modulation of immune responses to CMV reactivation in a population previously exposed to CMV infection.

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“…In the present study, our analyses focused on data from women in the third trimester. We know that blood pressure and vascular resistance decline during the second trimester before returning to pre-pregnant values during the late third trimester (Chapman et al 1998;Rebelo et al 2015;Wright et al 2015). The current evidence also suggests that sympathetic activity increases progressively with gestation (Reyes et al 2018b).…”

Section: Considerationsmentioning

confidence: 49%

Blunted sympathetic neurovascular transduction during normotensive pregnancy

Steinback

Fraser

Usselman

et al. 2019

The Journal of Physiology

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Key points Normotensive pregnancy is associated with elevated sympathetic nervous system activity yet normal or reduced blood pressure. It represents a unique period of apparent healthy sympathetic hyperactivity. The present study models the blood pressure and heart rate (ECG R–R interval) responses to fluctuations in sympathetic nervous system activity aiming to understand neurocardiovascular transduction. The reported data clearly demonstrate that transduction of sympathetic nervous system signalling to systemic cardiovascular outcomes is reduced in normotensive pregnancy. These data are important for understanding how blood pressure regulation adapts during normotensive pregnancy and set the foundation for exploring similar mechanisms in hypertensive pregnancies. Abstract Previously, we described sympathetic nervous system hyperactivity yet decreased blood pressure responses to stress in normotensive pregnancy. To address the hypothesis that pregnant women have blunted neurocardiovascular transduction we assessed the relationship between spontaneous bursts of sympathetic nerve activity (SNA) and fluctuations in mean arterial blood pressure and R–R interval. Resting SNA, blood pressure and ECG were obtained in pregnant (third trimester, n = 18) and non‐pregnant (n = 18) women matched for age and pre‐/non‐pregnant body mass index. Custom software modelled beat‐by‐beat pressure (photoplethysmography) and R–R interval in relation to sequences of SNA bursts and non‐bursts (peroneal microneurography). Sequences were grouped by the number of bursts and non‐bursts [singlets, doublets, triplets and quadruplet (four or more)] and mean blood pressure and R–R interval were tracked for 15 subsequent cardiac cycles. Similar sequences were overlaid and averaged. Peak mean pressure in relation to sequences of SNA was reduced in pregnant vs. non‐pregnant women (doublets: 1.6 ± 1.1 mmHg vs. 3.6 ± 3.1 mmHg, P < 0.05; triplets: 2.4 ± 1.2 mmHg vs. 3.4 ± 2.1 mmHg, P < 0.05; quadruplets: 3.0 ± 1.0 mmHg vs. 5.5 ± 3.7 mmHg, P < 0.05). The nadir R–R interval following burst sequences was also smaller in pregnant vs. non‐pregnant women (singlets: −0.01 ± 0.01 s vs. −0.04 ± 0.04 s, P < 0.05; doublets: −0.02 ± 0.03 s vs. −0.05 ± 0.04 s, P < 0.05; triplets: −0.02 ± 0.01 s vs. −0.07 ± 0.04 s, P < 0.05; quadruplets: −0.01 ± 0.01 s vs. −0.09 ± 0.09 s, P < 0.05). There were no differences between groups in the mean arterial pressure and R–R interval responses to non‐burst sequences. Our data clearly indicate blunted systemic neurocardiovascular transduction during normotensive pregnancy. We propose that blunted transduction is a positive adaptation protecting pregnant women from the cardiovascular consequences of sympathetic hyperactivity.

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Blood Pressure Variation Throughout Pregnancy According to Early Gestational BMI: A Brazilian Cohort

Cited by 30 publications

References 23 publications

Relationship between Mean Arterial Pressure, Uric Acid and Calcium with Xanthine Oxidase Activity and Fetal Outcome in Normotensive and Preeclampsia in a Nested Study

Relationship between Mean Arterial Pressure, Uric Acid and Calcium with Xanthine Oxidase Activity and Fetal Outcome in Normotensive and Preeclampsia in a Nested Study

Genetic variation in toll like Receptors 2, 7, 9 and interleukin-6 is associated with Cytomegalovirus infection in late pregnancy

Blunted sympathetic neurovascular transduction during normotensive pregnancy

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