Key result
In pregnant women with hypertension, a higher aortic augmentation index was associated with preeclampsia (AUC 0.80; 95% CI 0.59-1.00; p=0.04) and a shorter time-to-delivery.
Why the study?
Does aortic augmentation index (AIX%) predict time-to-delivery and preeclampsia in pregnant women with raised blood pressure?
Cohort (n=28)
Single-blind
Does aortic augmentation index (AIX%) predict time-to-delivery and preeclampsia in pregnant women with raised blood pressure?
Answers are grounded in this paper and cite their sources.
Aortic augmentation index is significantly higher in pregnant women with preeclampsia compared to gestational hypertension and predicts a shorter time-to-delivery.
OBJECTIVE: Preeclampsia is associated with arterial dysfunction and augmentation index (AIX%) is an established indicator of arterial dysfunction. Our aim was to investigate the relationship of AIX% with time-to-delivery and other outcomes in women admitted to an antenatal triage unit. METHODS: We recruited 28 women with singleton pregnancies attending antenatal triage ward for assessment of hypertension. After 10 min rest, seated brachial blood pressure (Omron HEM-757) and AIX% (SphygmoCor applanation tonometry pulse wave analysis, PWA) were measured by a single investigator; other clinicians remained blinded to PWA results. Routine assessment included cardiotocography, urine analysis and blood tests. Subsequent outcomes were extracted from the obstetric records. RESULTS: Mean AIX% was 19.7% (SD 11.5; range -4% to +36%), maternal age 31 years, gestation 37 weeks, brachial BP 145/95, proteinuria 39%. Nine women had preeclampsia at assessment and six subsequently developed preeclampsia. Median time-to-delivery was 10 d (IQR 1.6-25 d) and was shorter for AIX% ≥ 20% (median 8.9 versus 19.8 d). AIX% was higher with preeclampsia (24.0%; SD 9.5) versus gestational hypertension (15.2%; SD 12.4); absolute difference 8.8% (95%CI 0.1-17.5; p = 0.05). A one-point higher AIX% (adjusted for age, urate and gestation) was associated with 0.3 d (95%CI -0.5 to 0.0; p = 0.06) reduced time-to-delivery. A higher AIX% was also associated with induction for preeclampsia, severe preeclampsia, peripartum-anti-hypertensives and discharge-on-anti-hypertensives. Area under the curve (AUC) for AIX% predicting preeclampsia was 0.80 (95%CI 0.59-1.00; p = 0.04). CONCLUSION: AIX% is associated with time-to-delivery and other outcomes in pregnancy.
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Fullerton et al. (2014) conducted a cohort in Hypertension in pregnancy (n=28). Aortic augmentation index (AIX%) vs. Lower AIX% was evaluated on Time-to-delivery (MD -0.3 days per 1-point higher AIX%, 95% CI -0.5 to 0.0, p=0.06). In pregnant women with hypertension, a higher aortic augmentation index was associated with preeclampsia (AUC 0.80; 95% CI 0.59-1.00; p=0.04) and a shorter time-to-delivery.
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