Association between arterial stiffness and wave reflection with subsequent development of placental-mediated diseases during pregnancy

findings of a systematic review and meta-analysis

Mohamed Waseem Osman, Mintu Nath, Eamonn Breslin, Asma Khalil, David R Webb, Thompson G Robinson, Hatem A Mousa

Research output: Contribution to journalArticle

7 Citations (Scopus)

Abstract

OBJECTIVE: We present a comprehensive systematic review of published literature to examine, whether arterial stiffness and wave reflection measurements during pregnancy differed between healthy patients and patients with placental-mediated diseases including preeclampsia (PET), small for gestational age (SGA), fetal death, and placental abruption, and a quantitative assessment of the findings using the meta-analysis approach.

METHODS: We searched Medline, Embase, and The Cochrane Library for studies of arterial stiffness in pregnancy, analyzed pregnancy outcomes and conducted the meta-analysis of data evaluated by trimesters of pregnancy. Hemodynamic parameters evaluated included: pulse wave velocity (PWV), augmentation index (AIx), and augmentation index-75 (AIx-75).

RESULTS: We screened 2806 citations, reviewed 36 studies and included nine (n = 15 923) studies for further quantitative assessment. Compared with healthy pregnancy, measures of arterial stiffness and wave reflection were consistently increased among pregnant women who subsequently developed PET during all trimesters. In the first trimester, mean AIx-75 (%) in the PET group was significantly higher with estimated standardized mean difference (SMD) of 0.90 [95% confidence intervals (95% CI) 0.07-1.73; P = 0.034]. In the second trimester, the PET group had significantly higher PWV (m/s) with estimated SMD of 1.26 (95% CI 0.22-2.30; P = 0.018). Concerning the SGA group, mean AIx (%) was greater during the second trimester only: 65.5 (SD 15.6) vs. 57.0 (11.2), P < 0.01.

CONCLUSION: There is significant increase in arterial stiffness and wave reflection parameters among pregnant women who subsequently developed PET and SGA fetuses. Larger studies with consistent methodological designs are required to evaluate the role and usefulness of arterial stiffness and wave reflection measurements as a screening tool for placental-mediated diseases during pregnancy.

Original languageEnglish
Pages (from-to)1005-1014
Number of pages10
JournalJournal of Hypertension
Volume36
Issue number5
Early online date1 May 2018
DOIs
Publication statusPublished - May 2018

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Placenta Diseases
Vascular Stiffness
Meta-Analysis
Pregnancy
Gestational Age
Pulse Wave Analysis
Second Pregnancy Trimester
Pregnant Women
Confidence Intervals
Pregnancy Trimesters
Abruptio Placentae
Fetal Death
First Pregnancy Trimester
Pregnancy Outcome
Pre-Eclampsia
Libraries
Fetus
Age Groups
Hemodynamics

Keywords

  • Female
  • Fetal Growth Retardation/epidemiology
  • Humans
  • Infant, Newborn
  • Infant, Small for Gestational Age
  • Pre-Eclampsia/epidemiology
  • Pregnancy
  • Pregnancy Outcome
  • Pregnancy Trimesters
  • Pulse Wave Analysis
  • Vascular Stiffness

Cite this

Association between arterial stiffness and wave reflection with subsequent development of placental-mediated diseases during pregnancy : findings of a systematic review and meta-analysis. / Osman, Mohamed Waseem; Nath, Mintu; Breslin, Eamonn; Khalil, Asma; Webb, David R; Robinson, Thompson G; Mousa, Hatem A.

In: Journal of Hypertension, Vol. 36, No. 5, 05.2018, p. 1005-1014.

Research output: Contribution to journalArticle

Osman, Mohamed Waseem ; Nath, Mintu ; Breslin, Eamonn ; Khalil, Asma ; Webb, David R ; Robinson, Thompson G ; Mousa, Hatem A. / Association between arterial stiffness and wave reflection with subsequent development of placental-mediated diseases during pregnancy : findings of a systematic review and meta-analysis. In: Journal of Hypertension. 2018 ; Vol. 36, No. 5. pp. 1005-1014.
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abstract = "OBJECTIVE: We present a comprehensive systematic review of published literature to examine, whether arterial stiffness and wave reflection measurements during pregnancy differed between healthy patients and patients with placental-mediated diseases including preeclampsia (PET), small for gestational age (SGA), fetal death, and placental abruption, and a quantitative assessment of the findings using the meta-analysis approach.METHODS: We searched Medline, Embase, and The Cochrane Library for studies of arterial stiffness in pregnancy, analyzed pregnancy outcomes and conducted the meta-analysis of data evaluated by trimesters of pregnancy. Hemodynamic parameters evaluated included: pulse wave velocity (PWV), augmentation index (AIx), and augmentation index-75 (AIx-75).RESULTS: We screened 2806 citations, reviewed 36 studies and included nine (n = 15 923) studies for further quantitative assessment. Compared with healthy pregnancy, measures of arterial stiffness and wave reflection were consistently increased among pregnant women who subsequently developed PET during all trimesters. In the first trimester, mean AIx-75 ({\%}) in the PET group was significantly higher with estimated standardized mean difference (SMD) of 0.90 [95{\%} confidence intervals (95{\%} CI) 0.07-1.73; P = 0.034]. In the second trimester, the PET group had significantly higher PWV (m/s) with estimated SMD of 1.26 (95{\%} CI 0.22-2.30; P = 0.018). Concerning the SGA group, mean AIx ({\%}) was greater during the second trimester only: 65.5 (SD 15.6) vs. 57.0 (11.2), P < 0.01.CONCLUSION: There is significant increase in arterial stiffness and wave reflection parameters among pregnant women who subsequently developed PET and SGA fetuses. Larger studies with consistent methodological designs are required to evaluate the role and usefulness of arterial stiffness and wave reflection measurements as a screening tool for placental-mediated diseases during pregnancy.",
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T2 - findings of a systematic review and meta-analysis

AU - Osman, Mohamed Waseem

AU - Nath, Mintu

AU - Breslin, Eamonn

AU - Khalil, Asma

AU - Webb, David R

AU - Robinson, Thompson G

AU - Mousa, Hatem A

N1 - Supplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal's Website (http://www.jhypertension.com).

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N2 - OBJECTIVE: We present a comprehensive systematic review of published literature to examine, whether arterial stiffness and wave reflection measurements during pregnancy differed between healthy patients and patients with placental-mediated diseases including preeclampsia (PET), small for gestational age (SGA), fetal death, and placental abruption, and a quantitative assessment of the findings using the meta-analysis approach.METHODS: We searched Medline, Embase, and The Cochrane Library for studies of arterial stiffness in pregnancy, analyzed pregnancy outcomes and conducted the meta-analysis of data evaluated by trimesters of pregnancy. Hemodynamic parameters evaluated included: pulse wave velocity (PWV), augmentation index (AIx), and augmentation index-75 (AIx-75).RESULTS: We screened 2806 citations, reviewed 36 studies and included nine (n = 15 923) studies for further quantitative assessment. Compared with healthy pregnancy, measures of arterial stiffness and wave reflection were consistently increased among pregnant women who subsequently developed PET during all trimesters. In the first trimester, mean AIx-75 (%) in the PET group was significantly higher with estimated standardized mean difference (SMD) of 0.90 [95% confidence intervals (95% CI) 0.07-1.73; P = 0.034]. In the second trimester, the PET group had significantly higher PWV (m/s) with estimated SMD of 1.26 (95% CI 0.22-2.30; P = 0.018). Concerning the SGA group, mean AIx (%) was greater during the second trimester only: 65.5 (SD 15.6) vs. 57.0 (11.2), P < 0.01.CONCLUSION: There is significant increase in arterial stiffness and wave reflection parameters among pregnant women who subsequently developed PET and SGA fetuses. Larger studies with consistent methodological designs are required to evaluate the role and usefulness of arterial stiffness and wave reflection measurements as a screening tool for placental-mediated diseases during pregnancy.

AB - OBJECTIVE: We present a comprehensive systematic review of published literature to examine, whether arterial stiffness and wave reflection measurements during pregnancy differed between healthy patients and patients with placental-mediated diseases including preeclampsia (PET), small for gestational age (SGA), fetal death, and placental abruption, and a quantitative assessment of the findings using the meta-analysis approach.METHODS: We searched Medline, Embase, and The Cochrane Library for studies of arterial stiffness in pregnancy, analyzed pregnancy outcomes and conducted the meta-analysis of data evaluated by trimesters of pregnancy. Hemodynamic parameters evaluated included: pulse wave velocity (PWV), augmentation index (AIx), and augmentation index-75 (AIx-75).RESULTS: We screened 2806 citations, reviewed 36 studies and included nine (n = 15 923) studies for further quantitative assessment. Compared with healthy pregnancy, measures of arterial stiffness and wave reflection were consistently increased among pregnant women who subsequently developed PET during all trimesters. In the first trimester, mean AIx-75 (%) in the PET group was significantly higher with estimated standardized mean difference (SMD) of 0.90 [95% confidence intervals (95% CI) 0.07-1.73; P = 0.034]. In the second trimester, the PET group had significantly higher PWV (m/s) with estimated SMD of 1.26 (95% CI 0.22-2.30; P = 0.018). Concerning the SGA group, mean AIx (%) was greater during the second trimester only: 65.5 (SD 15.6) vs. 57.0 (11.2), P < 0.01.CONCLUSION: There is significant increase in arterial stiffness and wave reflection parameters among pregnant women who subsequently developed PET and SGA fetuses. Larger studies with consistent methodological designs are required to evaluate the role and usefulness of arterial stiffness and wave reflection measurements as a screening tool for placental-mediated diseases during pregnancy.

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KW - Infant, Newborn

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KW - Pregnancy Outcome

KW - Pregnancy Trimesters

KW - Pulse Wave Analysis

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