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指脉搏容积描记法可预测妊娠期高血压、子痫前期和妊娠期糖尿病。

Finger pulse plethysmography predicts gestational hypertension, preeclampsia and gestational diabetes.

机构信息

College of Medicine and Public Health, Flinders University.

Discipline of Biomedical Engineering, School of Electrical and Mechanical Engineering, The University of Adelaide, Adelaide, Australia.

出版信息

J Hypertens. 2024 Sep 1;42(9):1615-1623. doi: 10.1097/HJH.0000000000003775. Epub 2024 May 14.

Abstract

BACKGROUND

Pregnancy complications related to hypertension can affect both mother and newborn. Pulse wave attenuation (PWA) captured through fingertip photoplethysmography (PPG) provide valuable insights into maternal acute hemodynamic and autonomic vascular function. Here, we quantify the nocturnal dynamics of PWA during early pregnancy and assess their association with the development of gestational hypertension, preeclampsia and gestational diabetes.

METHODS

PWA dynamics were assessed on overnight polysomnography-derived PPG signals from a cohort of 2714 pregnant women (mean age: 26.8 ± 5.5 years) enrolled in the Nulliparous Pregnancy Outcomes Study: Monitoring Mothers-to-Be (nuMoM2b). We determined the average duration (PWA duration ) and depth (PWA depth ) of PWA events in all women.

RESULTS

Odds ratio (OR) analysis-adjusted common confounders indicates that an average PWA duration greater than 8.74 s was associated with the increased risk of gestational hypertension [OR = 1.75 (1.27-2.39), P  < 0.001]. Similarly, average PWA depth greater than 1.19 was associated with an increased risk of preeclampsia [OR = 1.53 (1.01-2.33), P  = 0.045] and gestational diabetes [OR = 1.66 (1.01-2.73), P  = 0.044].

CONCLUSION

PWA attenuation dynamics during early pregnancy predict the risk of developing gestational hypertension and diabetes condition for women in their later trimesters. Potentially obtainable from smart wearable consumer devices, PWA analysis offers a low-cost, accessible and scalable marker that can enhance the management of pregnancy-induced cardiometabolic issues.

摘要

背景

与高血压相关的妊娠并发症会影响母婴双方。通过指尖光体积描记法(PPG)捕获的脉搏波衰减(PWA)为了解产妇急性血液动力学和自主血管功能提供了有价值的信息。在这里,我们量化了妊娠早期 PWA 的夜间动态变化,并评估了其与妊娠期高血压、子痫前期和妊娠期糖尿病发展的关系。

方法

从参与 Nulliparous Pregnancy Outcomes Study: Monitoring Mothers-to-Be (nuMoM2b) 的 2714 名孕妇(平均年龄:26.8±5.5 岁)的 overnight 多导睡眠图衍生的 PPG 信号中评估 PWA 动态。我们确定了所有女性的 PWA 事件的平均持续时间(PWA 持续时间)和深度(PWA 深度)。

结果

经 OR 分析调整常见混杂因素后,平均 PWA 持续时间大于 8.74 s 与妊娠期高血压的风险增加相关[OR=1.75(1.27-2.39),P<0.001]。同样,平均 PWA 深度大于 1.19 与子痫前期的风险增加相关[OR=1.53(1.01-2.33),P=0.045]和妊娠期糖尿病[OR=1.66(1.01-2.73),P=0.044]。

结论

妊娠早期 PWA 衰减动力学可预测女性在妊娠后期发生妊娠期高血压和糖尿病的风险。从智能可穿戴消费设备中获得的 PWA 分析提供了一种低成本、易于获取和可扩展的标志物,可以增强对妊娠引起的心血管代谢问题的管理。

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