de Medeiros Lima Ricardo Luiz, de Azevedo Cortez Eduardo Gabriel, Fidelis Cleanderson Romualdo, de Lima Lucas Nobrega, Mamere Esther Cecin, Rego Rafael Andrade, de Lima Josivan Gomes, Jeronimo Selma Maria Bezerra
Echocardiography Laboratory, University Hospital Onofre Lopes, Federal University of Rio Grande Do Norte, Natal, Rio Grande Do Norte, Brazil.
Medical School, Health Sciences Center, Federal University of Rio Grande Do Norte, Natal, Rio Grande Do Norte, Brazil.
BMC Pregnancy Childbirth. 2025 Sep 2;25(1):923. doi: 10.1186/s12884-025-08006-z.
Hypertensive disorders of pregnancy, including preeclampsia, are common in socioeconomic vulnerable populations worldwide. Approximately one third of women who have those disorders will maintain with hypertension, after pregnancy. This work aimed to determine the prevalence of hypertensive disorder of pregnancy in Natal, Brazil, and to use echocardiography to study cardiac function: (1) during pregnancy, and (2) at post partum in those who developed severe preeclampsia.
A prospective study after the 7th week of gestation (n = 107) and a cross-sectional study of preeclampsia cases (n = 18) were performed in Natal, Brazil. Data included clinical history, weight, height, age, and transthoracic echocardiogram. Descriptive and exploratory, paired and unpaired Student t-tests, univariate and logistic regression analyses were performed.
Among the 87 women who were fully studied prospectively, age varied between 15.2 - 43.2 years (28.1 ± 6.3) and 9.2% of participants developed hypertension. Notably, 61 (70.1%) had a high body mass index (BMI) of > 25 kg/m. There was myocardial hypertrophy or left ventricular remodeling in 12 subjects (13.8%); ejection fraction under 50% in 4 subjects (4.6%) and echocardiographic evidence of reduced left ventricular global longitudinal strain in 6 (6.9%). Women who developed hypertension had higher BMIs and larger left ventricular mass index. Post-partum women who had severe preeclampsia showed increase in the mean left ventricle relative wall thickness (p = 0.0167) and mean left ventricular isovolumic relaxation time (p = 0.0004) after a mean of a month post-delivery.
There is high prevalence of hypertensive disorder of pregnancy in underprivileged women from Natal, Brazil. Transthoracic echocardiography can identify early ventricular dysfunction in pre- and post-pregnancy and it may be a useful tool to guide in therapeutic strategies to prevent complications.
包括先兆子痫在内的妊娠高血压疾病在全球社会经济弱势群体中很常见。患有这些疾病的女性中约有三分之一在产后会持续患有高血压。这项研究旨在确定巴西纳塔尔市妊娠高血压疾病的患病率，并使用超声心动图研究心脏功能：（1）在怀孕期间，以及（2）在发生严重先兆子痫的产妇产后的心脏功能。
在巴西纳塔尔市进行了一项妊娠第7周后的前瞻性研究（n = 107）和一项先兆子痫病例的横断面研究（n = 18）。数据包括临床病史、体重、身高、年龄和经胸超声心动图。进行了描述性和探索性分析、配对和非配对学生t检验、单变量和逻辑回归分析。
在87名接受前瞻性全面研究的女性中，年龄在15.2至43.2岁之间（28.1±6.3），9.2%的参与者患了高血压。值得注意的是，61名（70.1%）的体重指数（BMI）>25 kg/m²。12名受试者（13.8%）出现心肌肥厚或左心室重塑；4名受试者（4.6%）的射血分数低于50%，6名（6.9%）有超声心动图证据显示左心室整体纵向应变降低。患高血压的女性BMI更高，左心室质量指数更大。患有严重先兆子痫的产后女性在分娩后平均一个月后，平均左心室相对壁厚增加（p = 0.0167），平均左心室等容舒张时间增加（p = 0.0004）。
巴西纳塔尔市贫困女性中妊娠高血压疾病的患病率很高。经胸超声心动图可以识别妊娠前后早期的心室功能障碍，它可能是指导预防并发症治疗策略的有用工具。
