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AUGMENTATION INDEX AND PULSE WAVE VELOCITY AFTER DELIVERY IN WOMEN WITH AND WITHOUT AN ADVERSE PREGNANCY OUTCOME

Abstract

Marnie Kelly McLean, Paige Wilbanks, Brooke Wilson, Marcey Jiles, Kaitlyn Ramey, Seth Byland, Abbi Lane-Cordova. University of South Carolina, Columbia, SC.

Adverse pregnancy outcomes (APOs), such as preterm birth, gestational diabetes, and hypertensive disorders of pregnancy, are associated with higher maternal risk of cardiovascular disease years later. Research is limited regarding sensitive measures of vascular function in the early years following delivery. Purpose: To determine if women with a history of APO have differential wave reflection and arterial stiffness in the 6 months to 3 years following delivery. Methods: Seventy-nine women (mean age=32.7±0.6 years; 58 White/19 Black/1 Asian; 31 [39.2%] with a past APO) who delivered a singleton infant 6 months-3 years ago were included. Women were excluded if they were smokers, had diabetes, or used protease inhibitors. Following an overnight fast, participants completed a single study visit where brachial blood pressure was measured using an oscillometric cuff and applanation tonometry. Wave reflection (augmentation index; AIx) and central arterial stiffness (central pulse wave velocity; cPWV) were assessed. History of APO was determined via self-report. Wilcoxon rank-sum tests or t-tests were used to test for differences in means between APO groups. Results: Body mass index was higher in women who had an APO (31.8±1.4 vs 26.5±1.1 kg/m2, p<0.01). There was no difference in AIx (18.3±1.5 vs 16.9±1.9%; p=0.577), cPWV (6.02±0.29 vs 5.99±0.20 m/s; p=0.913), or brachial systolic blood pressure (116.5±3.3 vs 109.0±1.7 mmHg; p=0.101) between those with versus without APOs. Brachial diastolic blood pressure was significantly higher in women who had experienced an APO (75.9±2.6 vs 68.3±1.5 mmHg; p<0.01). AIx tended to be higher in women over age 30 years with a past APO (21.5±1.8 vs 17.1±1.9%; p=0.059). Conclusions: Women with and without APOs exhibited similar AIx and cPWV, though a trend towards higher AIx emerged in women over 30 with a past APO. Future research should evaluate differences in AIx and cPWV at more distant time points after delivery.

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