Augmentation index and pulse wave velocity in normotensive and pre-eclamptic pregnancies

Abstract

Objective Hypertensive disorders during pregnancy remain a major health burden. Normal pregnancy is associated with systemic cardiovascular adaptation. The augmentation index and pulse wave velocity measures may serve as surrogate markers of cardiovascular pathology, including pre-eclampsia. We evaluated these parameters during and after normotensive and pre-eclamptic pregnancies. Design Longitudinal cohort trial involving a case-control analysis of healthy women and women with pre-eclampsia. Setting University hospital. Population Fifty-three healthy pregnant women between 11+6 and 13+6 gestational weeks, as well as 21 patients with pre-eclampsia. Methods The augmentation index and pulse wave velocity were measured seven times during pregnancy and postpartum. Main outcome measures Changes in augmentation index and pulse wave velocity during and after healthy pregnancies were measured. The influence of early-onset and late-onset pre-eclampsia on these measurements both during and after pregnancy was evaluated. Results The normotensive pregnancies exhibited a significant decrease in the augmentation index from the first trimester to the end of the second trimester; however, the normotensive pregnancies showed an increase in the augmentation index during the third trimester as term approached. The patients with early-onset and late-onset pre-eclampsia displayed a significantly elevated augmentation index during pregnancy. The postpartum augmentation index and pulse wave velocity were significantly elevated in the early-onset pre-eclampsia group. Conclusion After pregnancy, early-onset and late-onset pre-eclamptic patients exhibit differences in vascular function. This result indicates the presence of a higher cardiovascular risk in patients after early-onset pre-eclampsia. © 2013 Nordic Federation of Societies of Obstetrics and Gynecology.