Eastabrook Genevieve, Murray Erin, Bedell Samantha, Miller Michael R, Siu Samuel, de Vrijer Barbra
The Department of Obstetrics and Gynaecology, The University of Western Ontario, London ON; Children's Health Research Institute, London, ON.
The Department of Family Medicine, University of Ottawa, Ottawa, ON.
J Obstet Gynaecol Can. 2025 May;47(5):102665. doi: 10.1016/j.jogc.2024.102665. Epub 2024 Sep 21.
Obesity is one of the most prevalent risk factors for hypertensive disorders of pregnancy (HDP); however, the role of pre-pregnancy cardiometabolic health in the development of these conditions is not well understood. Carotid-femoral pulse wave velocity (PWV) is an established measure of arterial stiffness and cardiovascular health and is validated in pregnancy. Our objective was to examine the obesity-related changes in PWV in pregnant individuals with and without HDP.
Overall, 87 individuals with singleton pregnancies were recruited and classified into 2 groups: cases (HDP: including pre-existing/chronic hypertension, gestational hypertension, preeclampsia, or intrauterine growth restriction; n = 39) and normotensive controls (no HDP or intrauterine growth restriction; n = 48). Patient data, including BMI, were collected from patient charts. Measurements of PWV were performed weekly until discharge or delivery (gestational age 23-38 weeks) and placental growth factor (PlGF) was measured at routine blood draws.
PWV did not significantly change over gestation for either group. Cases had significantly increased PWV and decreased PlGF compared to normotensive controls. An elevated BMI was associated with higher PWV in both cases and controls. Once grouped based on BMI, PWV was only significantly higher in cases with a BMI ≥25 kg/m compared to controls, whereas PlGF was less affected by BMI. As PWV increased, PlGF decreased; however, after controlling for BMI, there was no relationship between PWV and PlGF.
PWV measurements in early pregnancy may be useful as an additional independent marker to PlGF for risk-stratifying for HDP, especially in individuals with increased BMI.
肥胖是妊娠期高血压疾病（HDP）最常见的危险因素之一；然而，孕前心脏代谢健康在这些疾病发展中的作用尚未得到充分了解。颈股脉搏波速度（PWV）是一种既定的动脉僵硬度和心血管健康指标，且已在孕期得到验证。我们的目的是研究有无HDP的孕妇中与肥胖相关的PWV变化。
总共招募了87名单胎妊娠个体，并将其分为两组：病例组（HDP：包括孕前/慢性高血压、妊娠期高血压、子痫前期或胎儿生长受限；n = 39）和血压正常对照组（无HDP或胎儿生长受限；n = 48）。从患者病历中收集包括BMI在内的患者数据。每周进行PWV测量，直至出院或分娩（孕龄23 - 38周），并在常规抽血时测量胎盘生长因子（PlGF）。
两组的PWV在妊娠期均无显著变化。与血压正常对照组相比，病例组的PWV显著升高，PlGF降低。BMI升高与病例组和对照组的PWV升高均相关。一旦根据BMI分组，BMI≥25 kg/m²的病例组PWV仅显著高于对照组，而PlGF受BMI的影响较小。随着PWV升高，PlGF降低；然而，在控制BMI后，PWV与PlGF之间无相关性。
孕早期的PWV测量可能作为PlGF之外的另一个独立标志物，用于HDP的风险分层，尤其是在BMI升高的个体中。
