Maternal hemodynamics at 11–13 weeks of gestation and preterm birth

Khalil, Asma; Elkhouli, M.; Garcia-Mandujano, R.; Chiriac, Roxana; Nicolaides, Kypros H.

doi:10.1002/uog.11154

Cited by 9 publications

(9 citation statements)

References 31 publications

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“…These findings have been reproduced in both the early antepartum as well as the early postpartum phases. 102,103…”

Section: Preterm Delivery and Cvd Riskmentioning

confidence: 99%

“…These findings have been reproduced in both the early antepartum as well as the early postpartum phases. 102,103 Infant Birth Weight, Fetal Growth, and CVD Infant birth weight has been independently associated with maternal CVD risk. In the Women's Health Initiative (WHI), delivery of a low-birth-weight infant was independently associated with increased maternal ASCVD risk after adjustment for conventional risk factors and other APOs (adjusted OR, 1.25).…”

Section: Preterm Delivery and Cvd Riskmentioning

confidence: 99%

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Pregnancy and Reproductive Risk Factors for Cardiovascular Disease in Women

O’Kelly

Michos

Shufelt

et al. 2022

Circulation Research

135

121

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Beyond conventional risk factors for cardiovascular disease, women face an additional burden of sex-specific risk factors. Key stages of a woman’s reproductive history may influence or reveal short- and long-term cardiometabolic and cardiovascular trajectories. Early and late menarche, polycystic ovary syndrome, infertility, adverse pregnancy outcomes (eg, hypertensive disorders of pregnancy, gestational diabetes, preterm delivery, and intrauterine growth restriction), and absence of breastfeeding are all associated with increased future cardiovascular disease risk. The menopause transition additionally represents a period of accelerated cardiovascular disease risk, with timing (eg, premature menopause), mechanism, and symptoms of menopause, as well as treatment of menopause symptoms, each contributing to this risk. Differences in conventional cardiovascular disease risk factors appear to explain some, but not all, of the observed associations between reproductive history and later-life cardiovascular disease; further research is needed to elucidate hormonal effects and unique sex-specific disease mechanisms. A history of reproductive risk factors represents an opportunity for comprehensive risk factor screening, refinement of cardiovascular disease risk assessment, and implementation of primordial and primary prevention to optimize long-term cardiometabolic health in women.

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“…These findings have been reproduced in both the early antepartum as well as the early postpartum phases. 102,103…”

Section: Preterm Delivery and Cvd Riskmentioning

confidence: 99%

Section: Preterm Delivery and Cvd Riskmentioning

confidence: 99%

Pregnancy and Reproductive Risk Factors for Cardiovascular Disease in Women

O’Kelly

Michos

Shufelt

et al. 2022

Circulation Research

135

121

View full text Add to dashboard Cite

show abstract

“…However, central BP may be more indicative of the pathophysiology of cardiovascular disease than brachial BP, because central BP is affected by arterial stiffness and pulse wave reflection in the arterial tree [10]; both of which are independent predictors of cardiovascular outcome later in life [11,12]. Indeed, central BP and arterial stiffness are reported to be higher in the clinical [13] and preclinical [14] phases of preeclampsia compared with normal pregnancies and are increasingly used in the prediction of preeclampsia [15] and to monitor response to antihypertensive therapy [16]. However, longitudinal changes in central BP, pulse wave reflection [6,7,13] and aortic stiffness [13,17] during normal pregnancy have only ever been described in relation to a first trimester [6,7,13], or postpartum [13,17] reference baseline.…”

mentioning

confidence: 96%

A longitudinal study of maternal cardiovascular function from preconception to the postpartum period

Mahendru

Everett

Wilkinson

et al. 2014

Journal of Hypertension

203

145

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We have shown that normal pregnancy, irrespective of parity, is associated with significant changes commencing very early in pregnancy, continuing throughout pregnancy, and some of these changes persisted postpartum. Therefore, first trimester or postpartum baselines will underestimate the true extent of pregnancy-related changes. Prospective studies of cardiovascular function from preconception to postpartum will provide more reliable estimates of the influence of cardiovascular maladaptation during pregnancy complications and their effect on longer term cardiovascular function.

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“…They found that women with medically indicated preterm delivery had significantly higher arterial stiffness (increased augmentation index but no difference in pulse wave velocity) than women with sPTD and term delivery, 46 and lower augmentation index in sPTD <34 weeks. 46 There are limited data assessing differences in vascular stiffness in women with sPTD during pregnancy and the postpartum period. A potential hypothesis for Khalil's finding may be that sPTD has a different vascular response than other adverse pregnancy outcomes s indicating an alternative mechanistic pathway which warrants additional inquiry.…”

Section: Vascular Function In Preterm Deliverymentioning

confidence: 99%

“…In an initial report of the use of non-invasive pulse wave velocity and augmentation index in the context of sPTD, Khalil et al 46 studied arterial stiffness in women with all preterm delivery compared to controls at 11 to 13 weeks' gestation and compared three cohorts: 1) medically indicated preterm delivery, 2)sPTD, and 3) term deliveries. They found that women with medically indicated preterm delivery had significantly higher arterial stiffness (increased augmentation index but no difference in pulse wave velocity) than women with sPTD and term delivery, 46 and lower augmentation index in sPTD <34 weeks. 46 There are limited data assessing differences in vascular stiffness in women with sPTD during pregnancy and the postpartum period.…”

Section: Vascular Function In Preterm Deliverymentioning

confidence: 99%

Association of Spontaneous Preterm Delivery and Future Maternal Cardiovascular Disease

et al. 2018

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Cardiovascular disease (CVD) risk factors are well established. However, little is known about a woman's cardiovascular response to pregnancy, which appears to be an early marker of future maternal CVD risk. Spontaneous preterm delivery (sPTD) has been associated with a ≤3-fold increased risk of maternal CVD death later in life compared with having a term delivery. This review focuses on 3 key areas to critically assess the association of sPTD and future maternal CVD risk: (1) CVD risk factors, (2) inflammatory biomarkers of interest, and (3) specific forms of vascular dysfunction, such as endothelial function and arterial stiffness, and mechanisms by which each may be linked to sPTD. The association of sPTD with subsequent future maternal CVD risk suggests that a woman's abnormal response to pregnancy may serve as her first physiological stress test. These findings suggest that future research is needed to understand why women with sPTD may be at risk for CVD to implement effective interventions earlier in a woman's life.

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Maternal hemodynamics at 11–13 weeks of gestation and preterm birth

Abstract: Objective Women who experience preterm birth (PTB)

Cited by 9 publications

References 31 publications

Pregnancy and Reproductive Risk Factors for Cardiovascular Disease in Women

Pregnancy and Reproductive Risk Factors for Cardiovascular Disease in Women

A longitudinal study of maternal cardiovascular function from preconception to the postpartum period

Association of Spontaneous Preterm Delivery and Future Maternal Cardiovascular Disease

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