Woolcock Helen, Katsidoniotaki Maria, Taliadouros Meng Leonidas, Haghighi Noora, van Wingerden Anne-Sophie, Alian Aymen, Booker Whitney A, Bello Natalie A, Marshall Randolph S, Kougioumtzoglou Ioannis A, Petersen Nils H, Miller Eliza C
Department of Neurology, Columbia University, New York, NY, United States of America.
Department of Obstetrics and Gynecology, New York University, New York, NY, United States of America.
Physiol Meas. 2025 Sep 17;46(9). doi: 10.1088/1361-6579/adfeb4.
. Impaired cerebral autoregulation could contribute to postpartum stroke risk in individuals with preeclampsia. We modeled aggregated static autoregulatory curves in the postpartum period in individuals with no hypertension, preeclampsia, and chronic hypertension with superimposed preeclampsia.. This is a retrospective analysis of data from a prospective observational study of postpartum participants. We measured continuous mean arterial pressure (MAP) with finger plethysmography and cerebral blood velocity (CBv) with transcranial Doppler within 2 weeks after delivery. Data were aggregated and group curves generated from normalized MAP and CBv data using 3rd order polynomial equations. We compared overall polynomial curve shapes between groups as well as pair-wise comparisons of autoregulatory range.. A total of 73 participants were enrolled: 21 (29%) normotensive, 31 (42%) with preeclampsia and 21 (29%) with superimposed preeclampsia. Polynomial-curves suggested a flatter plateau in the normotensive group compared with both preeclampsia groups, but the differences were not statistically significant. Autoregulatory range were wider in both preeclampsia groups than in the normotensive group, with a MAP range of 27.5 mmHg in the normotensive group, 43.2 mmHg in the preeclampsia group, and 31.5 mmHg in the superimposed preeclampsia group, but only the difference between the preeclampsia and normotensive groups reached statistical significance (= 0.02).. Static autoregulation curves generated using third-order polynomials showed distinct characteristics in postpartum participants with normotension, preeclampsia, and superimposed preeclampsia, and suggested a wider cerebral autoregulatory range in those with preeclampsia.
脑自动调节功能受损可能会增加子痫前期患者产后中风的风险。我们模拟了产后无高血压、子痫前期以及合并子痫前期的慢性高血压患者的总体静态自动调节曲线。这是一项对产后参与者前瞻性观察研究数据的回顾性分析。我们在分娩后2周内,使用手指体积描记法测量连续平均动脉压(MAP),并使用经颅多普勒测量脑血流速度(CBv)。数据汇总后,使用三阶多项式方程从标准化的MAP和CBv数据生成组曲线。我们比较了各组之间的总体多项式曲线形状以及自动调节范围的两两比较。总共招募了73名参与者:21名(29%)血压正常,31名(42%)患有子痫前期,21名(29%)患有合并子痫前期。多项式曲线表明,与两个子痫前期组相比,血压正常组的平台期更平坦,但差异无统计学意义。两个子痫前期组的自动调节范围均比血压正常组宽,血压正常组的MAP范围为27.5 mmHg,子痫前期组为43.2 mmHg,合并子痫前期组为31.5 mmHg,但只有子痫前期组与血压正常组之间的差异达到统计学意义(=0.02)。使用三阶多项式生成的静态自动调节曲线在产后血压正常、子痫前期和合并子痫前期的参与者中表现出不同特征,表明子痫前期患者的脑自动调节范围更宽。