In normal pregnancy, arterial stiffness parameters including augmentation pressure and augmentation index fell significantly from the first to the second trimester and rose again in the third (P<0.001).
Observational (n=541)
No
This study establishes normal reference ranges for pulse wave analysis parameters across all three trimesters of healthy pregnancy, demonstrating a mid-pregnancy dip in arterial stiffness with no significant differences between Caucasian and Afrocaribbean women.
p-value: p=<0.001
BACKGROUND: Outside pregnancy, arterial pulse wave analysis provides valuable information in hypertension and vascular disease. Studies in pregnancy using this technique show that vascular stiffness is raised in women with established pre-eclampsia. We aimed to establish normal ranges for parameters of pulse wave analysis in normal pregnancy and to compare different ethnic groups. METHODOLOGY/PRINCIPAL FINDINGS: This prospective study was conducted at The Homerton University Hospital, London between January 2006 and March 2007. Using applanation tonometry, the radial artery pulse waveform was recorded and the aortic waveform derived. Augmentation pressure (AP) and Augmentation Index at heart rate 75/min (AIx-75), measures of arterial stiffness, were calculated. We recruited 665 women with singleton pregnancies. Women who developed pre-eclampsia (n = 24, 3.6%) or gestational hypertension (n = 36, 5.4%) were excluded. We also excluded 47 women with other pregnancy complications or incomplete follow-up, leaving 541 healthy normotensive pregnant women for subsequent analysis. In the overall group of 541 women, there were no significant changes in AP or AIx-75 as pregnancy progressed. In 45 women followed longitudinally, AP and AIx-75 fell significantly from the first to the second trimester, then rose again in the third (P<0.001). The two main ethnic groups represented were Caucasian (n = 229) and Afrocaribbean (n = 216). There were no significant differences in AP or AIx-75 in any trimester between these two ethnic groups. CONCLUSIONS: This study is the largest to date of pulse wave analysis in normal pregnancy, the first to report on a subset of women studied longitudinally, and the first to investigate the effect of ethnicity. These data provide the foundation for further investigation into the potential role of this technique in vascular disorders in pregnancy.
Khalil et al. (Thu,) conducted a observational in Normal pregnancy (n=541). Pulse wave analysis vs. Different trimesters and ethnic groups (Caucasian vs Afrocaribbean) was evaluated on Changes in augmentation pressure (AP) and augmentation index (AIx-75) across trimesters (p=<0.001). In normal pregnancy, arterial stiffness parameters including augmentation pressure and augmentation index fell significantly from the first to the second trimester and rose again in the third (P<0.001).