P5.04 ARTERIAL STIFFNESS AND WAVE REFLECTIONS DECREASE DURING PREGNANCY

Abstract

Objective: Studies on changes in arterial stiffness and wave reflections during pregnancy are limited to cross-sectional studies. Our aim was to investigate maternal hemodynamic and cardiovascular adaptations at each trimester of pregnancy in a prospective longitudinal case-control study. Methods: Cardiovascular measurements were performed at 12, 20 and 35 weeks of gestation, and included peripheral (Omron M6) and central (Sphygmocor) blood pressures, wave reflection and arterial stiffness measures (Sphygmocor and Esaote AU5 Wall track system). Results: 109 healthy women with a normal pregnancy (mean age 29.3y, range 21–42) and 26 healthy non-pregnant control subjects (mean age 28.4y, range 21–40) were included. Except for peripheral and central systolic blood pressure, all cardiovascular parameters showed significant (p<0.05) changes during pregnancy. Heart rate increased linearly during pregnancy. In contrast, diastolic blood pressure (DBP), mean arterial pressure (MAP), augmentation index (AIx@75) and aortic stiffness (PWV) showed a typical V-shaped pattern, characterized by a significant drop from 12 to 20 weeks of gestation (DBP: −2.6 mm Hg; MAP: −1.6 mm Hg; AIx@75: −10.0 %; PWV: −0.6 m/s), followed by a rise (DBP: +4.2 mm Hg; MAP +4.0 mm Hg) or smaller drop (AIx@75: − 7.8 % ; PWV: −0.4 m/s) at 35 compared to 12 weeks of gestation. Conclusions: The present longitudinal case-control study confirms the results of previous cross-sectional studies on peripheral and central hemodynamics. In addition, it shows a drop in wave reflection and arterial stiffness which may be due to vasodilation in the second and third trimester of pregnancy.