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Change in maternal cardiac output from preconception to mid-pregnancy is associated with birth weight in healthy pregnancies.

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cam.issuedOnline2017-01-05
dc.contributor.authorMahendru, AA
dc.contributor.authorFoo, FL
dc.contributor.authorMcEniery, CM
dc.contributor.authorEverett, TR
dc.contributor.authorWilkinson, IB
dc.contributor.authorLees, CC
dc.contributor.orcidLees, CC [0000-0002-2104-5561]
dc.date.accessioned2018-11-22T00:33:13Z
dc.date.available2018-11-22T00:33:13Z
dc.date.issued2017-01
dc.description.abstractOBJECTIVE: Birth weight (BW) is thought to be determined by maternal health and genetic, nutritional and placental factors, the latter being influenced by anatomical development and perfusion. Maternal cardiovascular changes contribute to uteroplacental perfusion; however, they have not yet been investigated in relation to fetal growth or BW. Our aim was to explore the relationship between maternal cardiovascular adaptation, fetal growth and BW in healthy pregnancies. METHODS: This was a longitudinal prospective study of women planning to conceive a pregnancy. Maternal cardiac output (CO), cardiac index (CI), pulse-wave velocity, aortic augmentation index, central blood pressure and peripheral vascular resistance were assessed prior to pregnancy and at 6, 23 and 33 weeks' gestation. Fetal growth was assessed using serial ultrasound measurements of biometry. RESULTS: In total, 143 women volunteered to participate and were eligible for study inclusion. A total of 101 women conceived within 18 months and there were 64 live births with normal pregnancy outcome. There were positive correlations between BW and the pregnancy-induced changes in CO (ρ = 0.4, P = 0.004), CI (ρ = 0.3, P = 0.02) and peripheral vascular resistance (ρ = 0.3, P = 0.02). There were significant associations between second-to-third-trimester fetal weight gain and the prepregnancy-to-second-trimester increase in CO (Δ, 0.8 ± 1.2 L/min; ρ = 0.3, P = 0.02) and CI (Δ, 0.4 ± 0.6 L/min/m2 ; ρ = 0.3, P = 0.04) and reduction in aortic augmentation index (Δ, -10 ± 9%; ρ = -0.3, P = 0.04). CONCLUSIONS: In healthy pregnancy, incremental changes in maternal CO in early pregnancy are associated with third-trimester fetal growth and BW. It is plausible that this association is causative as the changes predate third-trimester fetal growth and eventual BW. Copyright © 2016 ISUOG. Published by John Wiley & Sons Ltd.
dc.format.mediumPrint
dc.identifier.doi10.17863/CAM.33042
dc.identifier.eissn1469-0705
dc.identifier.issn0960-7692
dc.identifier.urihttps://www.repository.cam.ac.uk/handle/1810/285691
dc.languageeng
dc.language.isoeng
dc.publisherWiley
dc.publisher.urlhttp://dx.doi.org/10.1002/uog.17368
dc.subjectbirth weight
dc.subjectcardiac output
dc.subjecthemodynamics
dc.subjectpregnancy
dc.subjectvascular resistance
dc.subjectAdult
dc.subjectBirth Weight
dc.subjectBlood Pressure
dc.subjectCardiac Output
dc.subjectFemale
dc.subjectFetal Development
dc.subjectHumans
dc.subjectLongitudinal Studies
dc.subjectPregnancy
dc.subjectPregnancy Trimester, Second
dc.subjectProspective Studies
dc.titleChange in maternal cardiac output from preconception to mid-pregnancy is associated with birth weight in healthy pregnancies.
dc.typeArticle
dcterms.dateAccepted2016-11-14
prism.endingPage84
prism.issueIdentifier1
prism.publicationDate2017
prism.publicationNameUltrasound Obstet Gynecol
prism.startingPage78
prism.volume49
pubs.funder-project-idBritish Heart Foundation (None)
rioxxterms.licenseref.startdate2017-01
rioxxterms.licenseref.urihttp://www.rioxx.net/licenses/all-rights-reserved
rioxxterms.typeJournal Article/Review
rioxxterms.versionAM
rioxxterms.versionofrecord10.1002/uog.17368

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