von Wowern Emma, Källén Karin, Olofsson Per
Institution of Clinical Sciences Malmö, Lund University, Sweden; Dept. of Obstetrics and Gynecology, Skåne University Hospital, Malmö, Sweden.
Institution of Clinical Sciences Lund, Center for Reproductive Epidemiology, Tornblad Institute, Lund University, Lund, Sweden.
Pregnancy Hypertens. 2019 Jan;15:51-56. doi: 10.1016/j.preghy.2018.11.002. Epub 2018 Nov 13.
It might in the future be valuable to screen for increased maternal arterial stiffness, i.e. low compliance, since it is associated with development of hypertensive complications in pregnancy. Digital pulse wave analysis (DPA) is an easy and manageable method for arterial stiffness assessment. We aimed to investigate gestational influence on DPA variables longitudinally, and establish gestational age-adjusted reference values in normal pregnancy.
DPA measurements were performed longitudinally up to five times during pregnancy in 139 healthy women. Reference curves for DPA variables aging index (AI), b/a and d/a relative to gestational age were calculated with linear and polynomial mixed-effects models, and the influences of age and parity investigated with analysis of variance and analysis of covariance. A p < 0.05 was regarded significant.
All DPA variables were significantly associated with GA with best fit for a quadratic model. Arterial compliance peaked in the late second trimester. Age and parity independently influenced DPA variables but did not change the associations with gestational age.
DPA reflects longitudinal changes in arterial compliance in normal pregnancy but individual variance of DPA changes were greater than the influence of GA. Normal distributions of AI, b/a and d/a at 14-24 weeks are presented, but it remains to show whether these can be used to detect pathological hemodynamic alterations in pregnancy.
鉴于孕妇动脉僵硬度增加（即顺应性降低）与妊娠期高血压并发症的发生有关，未来对其进行筛查可能具有重要意义。数字脉搏波分析（DPA）是一种评估动脉僵硬度的简便且可操作的方法。我们旨在纵向研究孕期对DPA变量的影响，并建立正常妊娠中经孕周调整的参考值。
对139名健康女性在孕期进行了多达五次的纵向DPA测量。使用线性和多项式混合效应模型计算了DPA变量衰老指数（AI）、b/a和d/a相对于孕周的参考曲线，并通过方差分析和协方差分析研究了年龄和产次的影响。p < 0.05被视为具有统计学意义。
所有DPA变量均与孕周显著相关，二次模型拟合效果最佳。动脉顺应性在孕中期晚期达到峰值。年龄和产次独立影响DPA变量，但并未改变其与孕周的关联。
DPA反映了正常妊娠中动脉顺应性的纵向变化，但DPA变化的个体差异大于孕周的影响。给出了14 - 24周时AI、b/a和d/a的正态分布情况，但这些是否可用于检测妊娠中的病理性血流动力学改变仍有待证实。
