Maternal Cardiovascular Dysfunction is Associated with Hypoxic Cerebral and Umbilical Doppler Changes
Abstract
:1. Introduction
2. Materials and Methods
2.1. Ultrasound Assessment
2.2. Cardiovascular Assessment
2.3. Statistical Analysis
3. Results
3.1. Cardiovascular Changes in Pathological Pregnancy Outcome
3.2. Association between Maternal Cardiovascular Parameters and Doppler Indices
4. Discussion
5. Conclusions
Author Contributions
Funding
Conflicts of Interest
References
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Characteristic | Controls | Pre-Eclampsia | SGA/FGR | Pre-Eclampsia + SGA/FGR | Kruskal–Wallis p-Value |
---|---|---|---|---|---|
N. | 81 | 47 | 65 | 40 | - |
Mean maternal age, years (SD) | 32.9 (4.5) | 31.6 (4.4) | 32.1 (5.2) | 31.9 (5.1) | 0.276 |
Median BMI (range) | 23.9 (21.2–25.9) | 25.2 (22.7–29.1) | 24.1 (21.5–28.7) | 23.56 (22.5–27) | 0.082 |
N. of nulliparous (%) | 38 (46.9) | 39 (83) | 38 (58.5) | 24 (60) | - |
Median gestational age at CV test, weeks (IQR) | 33.6 (29.3–36.6) | 32.7 (28.1–35.9) | 32 (30.3–34.1) | 30.7 (26.6–33.5) | 0.026 |
Median gestation at delivery, weeks (IQR) | 39 (38–40) | 34.3 (31.6–37) 1 | 36.6 (32.6–37.9) 1 | 33.1 (27.7–35.8) 1 | <0.001 |
Median birthweight, g (IQR) | 3320 (3038.8–3552.5) | 1877.5 (1339.8–2685) 1 | 1990 (1280.5–2307.5) 1 | 1333 (704–1910) 1 | <0.001 |
Variable | Controls | Pre-Eclampsia | SGA/FGR | Pre-Eclampsia + SGA/FGR | Kruskal–Wallis p-Value | ||||
---|---|---|---|---|---|---|---|---|---|
N. | Mean z-Score (SD) | N. | Mean z-Score (SD) | N. | Mean z-Score (SD) | N. | Mean z-Score (SD) | ||
CO lying | 81 | −0.067 (0.96) | 45 | −0.009 (1.74) | 65 | −0.68 (1.34) | 40 | −0.51 (1.69) | 0.007 |
CO standing | 81 | 0.02 (1.04) | 47 | 0.35 (2.006) | 44 | −0.48 (1.24) | 33 | −0.82 (1.24) 1 | 0.002 |
PVR lying | 81 | 0.087 (0.92) | 45 | 1.696 (2.6) 2 | 64 | 1.52 (2.48) 2 | 39 | 2.56 (2.72) 2 | <0.001 |
PVR standing | 81 | 0.037 (0.92) | 47 | 1.22 (2.26) | 44 | 0.83 (1.84) | 33 | 2.96 (3.27) 3 | <0.001 |
Variable | Positive EDF | Absent/Negative EDF | p-Value (T-Test) | ||
---|---|---|---|---|---|
N. | Mean (SD) | N. | Mean (SD) | ||
Lying CO | 192 | −0.22 (1.41) | 22 | −0.97 (1.57) | 0.019 |
Lying PVR | 191 | 1.02 (2.12) | 21 | 2.88 (3.39) | 0.022 |
Standing CO | 174 | −0.03 (1.49) | 14 | −0.91 (1.04) | 0.03 |
Standing PVR | 174 | 0.69 (1.89) | 14 | 3.33 (4.01) | 0.029 |
Doppler Variable | Cardiovascular Variable | r2 | p-Value | Regression Equation |
---|---|---|---|---|
Uterine artery PI | Lying CO z-score | 0.007 | 0.499 | y = −0.005x + 0.008x2 + 0.894 |
Standing CO z-score | 0.024 | 0.135 | y = −0.037x + 0.015x2 + 0.868 | |
Umbilical artery PI | Lying CO z-score | 0.008 | 0.407 | y = −0.14x + 0.013x2 + 1.466 |
Standing CO z-score | 0.036 | 0.026 | y = −0.343x + 0.027x2 + 1.280 | |
Middle cerebral artery PI | Lying CO z-score | 0.052 | 0.029 | y = 0.106x − 0.056x2 − 0.669 |
Standing CO z-score | 0.018 | 0.389 | y = 0.135x − 0.016x2 − 0.826 |
Doppler Variable | Cardiovascular Variable | r2 | p-Value | Regression Equation |
---|---|---|---|---|
Uterine artery PI | Lying PVR z-score | 0.049 | 0.009 | y = 0.031x + 0.001x2 + 0.870 |
Standing PVR z-score | 0.054 | 0.011 | y = 0.060x − 0.004x2 + 0.867 | |
Umbilical artery PI | Lying PVR z-score | 0.06 | 0.001 | y = 0.310x − 0.01x2 + 1.234 |
Standing PVR z-score | 0.082 | <0.001 | y = 0.433x − 0.02x2 + 1.102 | |
Middle cerebral artery PI | Lying PVR z-score | 0.062 | 0.016 | y = −0.156x + 0.003x2 − 0.613 |
Standing PVR z-score | 0.045 | 0.088 | y = −0.167x + 0.007x2 − 0.722 |
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Masini, G.; Tay, J.; McEniery, C.M.; Wilkinson, I.B.; Valensise, H.; Tiralongo, G.M.; Farsetti, D.; Gyselaers, W.; Vonck, S.; Lees, C.C. Maternal Cardiovascular Dysfunction is Associated with Hypoxic Cerebral and Umbilical Doppler Changes. J. Clin. Med. 2020, 9, 2891. https://doi.org/10.3390/jcm9092891
Masini G, Tay J, McEniery CM, Wilkinson IB, Valensise H, Tiralongo GM, Farsetti D, Gyselaers W, Vonck S, Lees CC. Maternal Cardiovascular Dysfunction is Associated with Hypoxic Cerebral and Umbilical Doppler Changes. Journal of Clinical Medicine. 2020; 9(9):2891. https://doi.org/10.3390/jcm9092891
Chicago/Turabian StyleMasini, Giulia, Jasmine Tay, Carmel M McEniery, Ian B Wilkinson, Herbert Valensise, Grazia M Tiralongo, Daniele Farsetti, Wilfried Gyselaers, Sharona Vonck, and Christoph C. Lees. 2020. "Maternal Cardiovascular Dysfunction is Associated with Hypoxic Cerebral and Umbilical Doppler Changes" Journal of Clinical Medicine 9, no. 9: 2891. https://doi.org/10.3390/jcm9092891