Haemodynamic differences amongst women who were screened for gestational diabetes in comparison to healthy controls.

AIM

To assess the changes in haemodynamics amongst pregnant women who were screened for gestational diabetes mellitus (GDM) in comparison to low-risk healthy pregnant controls.

METHODOLOGY

A total of 120 pregnant women of mean (standard deviation) age 31.03 (5.41) years who attended their oral glucose tolerance test as part of the national screening for GDM (study), and 60 low-risk healthy pregnant women (control) of mean age 29.71 (5.33) years, were invited to participate in this study. All women included in the study booked at the University Hospitals of Leicester NHS Trust and fulfilled the relevant inclusion criteria. Non-invasive assessment of arterial stiffness and cardiac output were undertaken on participants between 26 and 28 weeks of pregnancy. The mean difference between GDM and low-risk group for each of the arterial stiffness and cardiac output measurements was assessed by a two-sample unpaired t-test.

RESULTS

Significant differences were found between the study and control groups for brachial (-64.5 vs. -69.5, p < 0.04) and aortic augmentation indices (5.2 vs. 2.7, p = 0.04), though there was no significant difference for PWV (8.3 vs. 8.1, p = 0.49). Cardiac output (7.6 vs. 7.0, p = 0.011), stroke volume (84.4 vs. 76.9, p = 0.013) and central mean arterial pressure (71 vs. 58, <0.001) were also significantly different between groups. However, no significant differences were reported for heart rate, systolic and diastolic blood pressure, or total peripheral resistance.

CONCLUSION

Pregnant women at risk of GDM between gestational weeks 26 and 28 had significantly increased measures of arterial stiffness, as assessed by brachial and aortic augmentation indices, compared with low-risk healthy controls. Whether these women are at greater long-term cardiovascular disease risk warrants further investigation.