Arterial stiffness and fetal growth in normotensive pregnancy

• Published in: American journal of hypertension 2005-03, Vol.18 (3), p.337-341
• Main Authors: Elvan-Tas̨pinar, Ayten, Franx, Arie, Bots, Michiel L., Koomans, Hein A., Bruinse, Hein W.
• Format: Article
• Language: English
• Subjects: Adaptation, Physiological - physiology; Adult; Arterial hypertension. Arterial hypotension; Arterial stiffness; Arteries - physiology; Biological and medical sciences; Birth Weight; Blood and lymphatic vessels; Blood Pressure - physiology; Cardiology. Vascular system; Clinical manifestations. Epidemiology. Investigative techniques. Etiology; Diseases of mother, fetus and pregnancy; Female; Fetal Development - physiology; Gynecology. Andrology. Obstetrics; Humans; Infant, Newborn; intrauterine growth; Medical sciences; normotensive pregnancy; Pregnancy - physiology; Pregnancy. Fetus. Placenta; Vascular Resistance - physiology
• ISSN: 0895-7061; 1879-1905; 1941-7225
• DOI: 10.1016/j.amjhyper.2004.10.020

Normal pregnancy is characterized by a decrease in peripheral resistance and generalized vasodilation resulting in plasma volume expansion, which is associated with intrauterine growth. Stiffness of the arterial system may be a measure of the degree of plasma volume expansion. Pulse wave velocity (PWV), measured by applanation tonometry, is a validated approach to determine arterial stiffness. Pulse pressure (PP) is considered a surrogate measure for arterial stiffness. The aim of this study was to evaluate the association between arterial stiffness and fetal growth. In 50 normotensive pregnancies, carotid-femoral PWV was measured in the third trimester in 30° lateral position. Blood pressure measurements were performed with conventional auscultatory sphygmomanometry. Birth weight centiles and weight centiles at the age of 6 months were recorded. Linear regression models were used for statistical analyses. There was a significant relationship in PWV with both birth weight centiles and catch-up growth after birth, independent of mean arterial pressure (MAP). An increase of 1 m/sec in PWV was associated with a decrease in birth weight centiles by 17.6% and a catch-up of 22.3% in weight centiles after birth. A stronger association was found for pulse pressure and birth weight centiles. An increase of 1 mm Hg was associated with a decrease in birth weight centiles by 1.8%. There was no association between MAP and birth weight centiles. In normotensive pregnancy arterial stiffness is associated with birth weight centile and catch-up growth after birth, independently from MAP. This suggests that arterial stiffness reflects maternal vascular adaptation to pregnancy better than blood pressure.