Buddeberg, BS; Sharma, R; O'Driscoll, JM; Kaelin Agten, A; Khalil, A; Thilaganathan, B
(2019)
Cardiac maladaptation in obese pregnant women at term.
Ultrasound Obstet Gynecol, 54 (3).
pp. 344-349.
ISSN 1469-0705
https://doi.org/10.1002/uog.20170
SGUL Authors: Thilaganathan, Baskaran
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Abstract
Objective Obesity is an increasing problem worldwide, with well recognized detrimental effects on cardiovascular health; however, very little is known about the effect of obesity on cardiovascular adaptation to pregnancy. The aim of the present study was to compare biventricular cardiac function at term between obese pregnant women and pregnant women with normal body weight, utilizing conventional echocardiography and speckle‐tracking assessment. Methods This was a prospective case–control study of 40 obese, but otherwise healthy, pregnant women with a body mass index (BMI) of ≥ 35 kg/m2 and 40 healthy pregnant women with a BMI of ≤ 30 kg/m2. All women underwent a comprehensive echocardiographic examination and speckle‐tracking assessment at term. Results Obese pregnant women, compared with controls, had significantly higher systolic blood pressure (117 vs 109 mmHg; P = 0.002), cardiac output (6.73 vs 4.90 L/min; P < 0.001), left ventricular (LV) mass index (74 vs 64 g/m2; P < 0.001) and relative wall thickness (0.43 vs 0.37; P < 0.001). Diastolic dysfunction was present in five (12.5%) controls and 16 (40%) obese women (P = 0.004). In obese women, compared with controls, LV global longitudinal strain (–15.59 vs –17.61%; P < 0.001), LV endocardial (–17.30 vs –19.84%; P < 0.001) and epicardial (–13.10 vs –15.73%; P < 0.001) global longitudinal strain as well as LV early diastolic strain rate (1.05 vs 1.24 /s; P = 0.006) were all significantly reduced. No differences were observed in the degree of LV twist and torsion between the two groups. Conclusions Morbidly obese, but otherwise healthy, pregnant women at term had significant LV hypertrophy with evidence of diastolic dysfunction and impaired deformation indices compared with pregnant women of normal weight. These findings are likely to represent a maladaptive response of the heart to volume overload in obese pregnancy. The impact of theses changes on pregnancy outcome and long‐term maternal outcome is unclear.
Item Type: | Article | ||||||||
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Additional Information: | This is the peer reviewed version of the following article: Buddeberg, B. S., Sharma, R. , O'Driscoll, J. M., Kaelin Agten, A. , Khalil, A. and Thilaganathan, B. (2019), Cardiac maladaptation in obese pregnant women at term. Ultrasound Obstet Gynecol, 54: 344-349., which has been published in final form at https://doi.org/10.1002/uog.20170. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Use of Self-Archived Versions. | ||||||||
Keywords: | Cardiac Dysfunction, Diastolic Dysfunction, Echocardiography, Obesity, Pregnancy, Speckle Tracking, 1114 Paediatrics And Reproductive Medicine, Obstetrics & Reproductive Medicine | ||||||||
SGUL Research Institute / Research Centre: | Academic Structure > Molecular and Clinical Sciences Research Institute (MCS) | ||||||||
Journal or Publication Title: | Ultrasound Obstet Gynecol | ||||||||
ISSN: | 1469-0705 | ||||||||
Language: | eng | ||||||||
Dates: |
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Publisher License: | Publisher's own licence | ||||||||
PubMed ID: | 30381850 | ||||||||
Go to PubMed abstract | |||||||||
URI: | https://openaccess.sgul.ac.uk/id/eprint/110328 | ||||||||
Publisher's version: | https://doi.org/10.1002/uog.20170 |
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