Measurement of aortic augmentation index in pregnant women with raised blood pressure and subsequent outcomes: a preliminary prospective cohort study

Gail Fullerton, Michael A. Crilly*, Sohinee Bhattacharya, Peter J. Danielian

*Corresponding author for this work

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

Objective: Preeclampsia is associated with arterial dysfunction and augmentation index (AIX%) is an established indicator of arterial dysfunction. Our aim was to investigate the relationship of AIX% with time-to-delivery and other outcomes in women admitted to an antenatal triage unit. Methods: We recruited 28 women with singleton pregnancies attending antenatal triage ward for assessment of hypertension. After 10 min rest, seated brachial blood pressure (Omron HEM-757) and AIX% (SphygmoCor applanation tonometry pulse wave analysis, PWA) were measured by a single investigator; other clinicians remained blinded to PWA results. Routine assessment included cardiotocography, urine analysis and blood tests. Subsequent outcomes were extracted from the obstetric records. Results: Mean AIX% was 19.7% (SD 11.5; range -4% to +36%), maternal age 31 years, gestation 37 weeks, brachial BP 145/95, proteinuria 39%. Nine women had preeclampsia at assessment and six subsequently developed preeclampsia. Median time-to-delivery was 10 d (IQR 1.6-25 d) and was shorter for AIX% ≥ 20% (median 8.9 versus 19.8 d). AIX% was higher with preeclampsia (24.0%; SD 9.5) versus gestational hypertension (15.2%; SD 12.4); absolute difference 8.8% (95%CI 0.1-17.5; p = 0.05). A one-point higher AIX% (adjusted for age, urate and gestation) was associated with 0.3 d (95%CI -0.5 to 0.0; p = 0.06) reduced time-to-delivery. A higher AIX% was also associated with induction for preeclampsia, severe preeclampsia, peripartum-anti-hypertensives and discharge-on-anti-hypertensives. Area under the curve (AUC) for AIX% predicting preeclampsia was 0.80 (95%CI 0.59-1.00; p = 0.04). Conclusion: AIX% is associated with time-to-delivery and other outcomes in pregnancy.

Original languageEnglish
Pages (from-to)476-487
Number of pages12
JournalHypertension in Pregnancy
Volume33
Issue number4
Early online date28 Jul 2014
DOIs
Publication statusPublished - Nov 2014

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Pre-Eclampsia
Pregnant Women
Cohort Studies
Prospective Studies
Blood Pressure
Pulse Wave Analysis
Triage
Pregnancy
Antihypertensive Agents
Arm
Cardiotocography
Peripartum Period
Pregnancy Induced Hypertension
Maternal Age
Manometry
Hematologic Tests
Pregnancy Outcome
Uric Acid
Proteinuria
Obstetrics

Keywords

  • augmentation index
  • applanation tonometry
  • hypertension
  • pregnancy
  • preeclampsia
  • pulse wave analysis

Cite this

@article{4e28800dc8c348418ffab16dd9cd3d93,
title = "Measurement of aortic augmentation index in pregnant women with raised blood pressure and subsequent outcomes: a preliminary prospective cohort study",
abstract = "Objective: Preeclampsia is associated with arterial dysfunction and augmentation index (AIX{\%}) is an established indicator of arterial dysfunction. Our aim was to investigate the relationship of AIX{\%} with time-to-delivery and other outcomes in women admitted to an antenatal triage unit. Methods: We recruited 28 women with singleton pregnancies attending antenatal triage ward for assessment of hypertension. After 10 min rest, seated brachial blood pressure (Omron HEM-757) and AIX{\%} (SphygmoCor applanation tonometry pulse wave analysis, PWA) were measured by a single investigator; other clinicians remained blinded to PWA results. Routine assessment included cardiotocography, urine analysis and blood tests. Subsequent outcomes were extracted from the obstetric records. Results: Mean AIX{\%} was 19.7{\%} (SD 11.5; range -4{\%} to +36{\%}), maternal age 31 years, gestation 37 weeks, brachial BP 145/95, proteinuria 39{\%}. Nine women had preeclampsia at assessment and six subsequently developed preeclampsia. Median time-to-delivery was 10 d (IQR 1.6-25 d) and was shorter for AIX{\%} ≥ 20{\%} (median 8.9 versus 19.8 d). AIX{\%} was higher with preeclampsia (24.0{\%}; SD 9.5) versus gestational hypertension (15.2{\%}; SD 12.4); absolute difference 8.8{\%} (95{\%}CI 0.1-17.5; p = 0.05). A one-point higher AIX{\%} (adjusted for age, urate and gestation) was associated with 0.3 d (95{\%}CI -0.5 to 0.0; p = 0.06) reduced time-to-delivery. A higher AIX{\%} was also associated with induction for preeclampsia, severe preeclampsia, peripartum-anti-hypertensives and discharge-on-anti-hypertensives. Area under the curve (AUC) for AIX{\%} predicting preeclampsia was 0.80 (95{\%}CI 0.59-1.00; p = 0.04). Conclusion: AIX{\%} is associated with time-to-delivery and other outcomes in pregnancy.",
keywords = "augmentation index, applanation tonometry, hypertension, pregnancy, preeclampsia, pulse wave analysis",
author = "Gail Fullerton and Crilly, {Michael A.} and Sohinee Bhattacharya and Danielian, {Peter J.}",
year = "2014",
month = "11",
doi = "10.3109/10641955.2014.946612",
language = "English",
volume = "33",
pages = "476--487",
journal = "Hypertension in Pregnancy",
issn = "1064-1955",
publisher = "Informa Healthcare",
number = "4",

}

TY - JOUR

T1 - Measurement of aortic augmentation index in pregnant women with raised blood pressure and subsequent outcomes

T2 - a preliminary prospective cohort study

AU - Fullerton, Gail

AU - Crilly, Michael A.

AU - Bhattacharya, Sohinee

AU - Danielian, Peter J.

PY - 2014/11

Y1 - 2014/11

N2 - Objective: Preeclampsia is associated with arterial dysfunction and augmentation index (AIX%) is an established indicator of arterial dysfunction. Our aim was to investigate the relationship of AIX% with time-to-delivery and other outcomes in women admitted to an antenatal triage unit. Methods: We recruited 28 women with singleton pregnancies attending antenatal triage ward for assessment of hypertension. After 10 min rest, seated brachial blood pressure (Omron HEM-757) and AIX% (SphygmoCor applanation tonometry pulse wave analysis, PWA) were measured by a single investigator; other clinicians remained blinded to PWA results. Routine assessment included cardiotocography, urine analysis and blood tests. Subsequent outcomes were extracted from the obstetric records. Results: Mean AIX% was 19.7% (SD 11.5; range -4% to +36%), maternal age 31 years, gestation 37 weeks, brachial BP 145/95, proteinuria 39%. Nine women had preeclampsia at assessment and six subsequently developed preeclampsia. Median time-to-delivery was 10 d (IQR 1.6-25 d) and was shorter for AIX% ≥ 20% (median 8.9 versus 19.8 d). AIX% was higher with preeclampsia (24.0%; SD 9.5) versus gestational hypertension (15.2%; SD 12.4); absolute difference 8.8% (95%CI 0.1-17.5; p = 0.05). A one-point higher AIX% (adjusted for age, urate and gestation) was associated with 0.3 d (95%CI -0.5 to 0.0; p = 0.06) reduced time-to-delivery. A higher AIX% was also associated with induction for preeclampsia, severe preeclampsia, peripartum-anti-hypertensives and discharge-on-anti-hypertensives. Area under the curve (AUC) for AIX% predicting preeclampsia was 0.80 (95%CI 0.59-1.00; p = 0.04). Conclusion: AIX% is associated with time-to-delivery and other outcomes in pregnancy.

AB - Objective: Preeclampsia is associated with arterial dysfunction and augmentation index (AIX%) is an established indicator of arterial dysfunction. Our aim was to investigate the relationship of AIX% with time-to-delivery and other outcomes in women admitted to an antenatal triage unit. Methods: We recruited 28 women with singleton pregnancies attending antenatal triage ward for assessment of hypertension. After 10 min rest, seated brachial blood pressure (Omron HEM-757) and AIX% (SphygmoCor applanation tonometry pulse wave analysis, PWA) were measured by a single investigator; other clinicians remained blinded to PWA results. Routine assessment included cardiotocography, urine analysis and blood tests. Subsequent outcomes were extracted from the obstetric records. Results: Mean AIX% was 19.7% (SD 11.5; range -4% to +36%), maternal age 31 years, gestation 37 weeks, brachial BP 145/95, proteinuria 39%. Nine women had preeclampsia at assessment and six subsequently developed preeclampsia. Median time-to-delivery was 10 d (IQR 1.6-25 d) and was shorter for AIX% ≥ 20% (median 8.9 versus 19.8 d). AIX% was higher with preeclampsia (24.0%; SD 9.5) versus gestational hypertension (15.2%; SD 12.4); absolute difference 8.8% (95%CI 0.1-17.5; p = 0.05). A one-point higher AIX% (adjusted for age, urate and gestation) was associated with 0.3 d (95%CI -0.5 to 0.0; p = 0.06) reduced time-to-delivery. A higher AIX% was also associated with induction for preeclampsia, severe preeclampsia, peripartum-anti-hypertensives and discharge-on-anti-hypertensives. Area under the curve (AUC) for AIX% predicting preeclampsia was 0.80 (95%CI 0.59-1.00; p = 0.04). Conclusion: AIX% is associated with time-to-delivery and other outcomes in pregnancy.

KW - augmentation index

KW - applanation tonometry

KW - hypertension

KW - pregnancy

KW - preeclampsia

KW - pulse wave analysis

U2 - 10.3109/10641955.2014.946612

DO - 10.3109/10641955.2014.946612

M3 - Article

C2 - 25068523

VL - 33

SP - 476

EP - 487

JO - Hypertension in Pregnancy

JF - Hypertension in Pregnancy

SN - 1064-1955

IS - 4

ER -