Maternal cardiovascular and endothelial function from first trimester to postpartum

Vassiliki Kolovetsiou-Kreiner, Manfred Georg Moertl, Ilona Papousek, Karin Schmid-Zalaudek, Uwe Lang, Dietmar Schlembach, Mila Cervar-Zivkovic, Helmut Karl Lackner

Research output: Contribution to journalArticleResearchpeer-review

Abstract

Objective To explore noninvasively the complex interactions of the maternal hemodynamic system throughout pregnancy and the resulting after-effect six weeks postpartum. Methods Eighteen women were tested beginning at the 12th week of gestation at six time-points throughout pregnancy and six weeks postpartum. Heart rate, heart rate variability, blood pressure, pulse transit time (PTT), respiration, and baroreceptor sensitivity were analyzed in resting conditions. Additionally, hemoglobin, asymmetric and symmetric dimethylarginine and Endothelin (ET-1) were obtained. Results Heart rate and sympathovagal balance favoring sympathetic drive increased, the vagal tone and the baroreflex sensitivity decreased during pregnancy. Relative sympathetic drive (sympathovagal balance) reached a maximum at 6 weeks postpartum whereas the other variables did not differ compared to first trimester levels. Postpartum diastolic blood pressure was higher compared to first and second trimester. Pulse transit time and endothelial markers showed no difference throughout gestation. However, opposing variables PTT and asymmetric dimethylarginine (ADMA) were both higher six weeks postpartum. Conclusions The sympathetic up regulation throughout pregnancy goes hand in hand with a decreased baroreflex sensitivity. In the postpartum period, the autonomic nervous system, biochemical endothelial reactions and PTT show significant and opposing changes compared to pregnancy findings, indicating the complex aftermath of the increase of blood volume, the changes in perfusion strategies and blood pressure regulation that occur in pregnancy.

Original languageEnglish
Article numbere0197748
JournalPLoS ONE
Volume13
Issue number5
DOIs
Publication statusPublished - 1 May 2018

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Blood pressure
First Pregnancy Trimester
Postpartum Period
Mothers
pregnancy
Pregnancy
Pulse Wave Analysis
Pressure regulation
Endothelins
Hemodynamics
Neurology
Blood Pressure
heart rate
Baroreflex
Heart Rate
Hemoglobins
Blood
blood pressure
autonomic nervous system
Pressoreceptors

ASJC Scopus subject areas

  • Biochemistry, Genetics and Molecular Biology(all)
  • Agricultural and Biological Sciences(all)

Cite this

Kolovetsiou-Kreiner, V., Moertl, M. G., Papousek, I., Schmid-Zalaudek, K., Lang, U., Schlembach, D., ... Lackner, H. K. (2018). Maternal cardiovascular and endothelial function from first trimester to postpartum. PLoS ONE, 13(5), [e0197748]. https://doi.org/10.1371/journal.pone.0197748

Maternal cardiovascular and endothelial function from first trimester to postpartum. / Kolovetsiou-Kreiner, Vassiliki; Moertl, Manfred Georg; Papousek, Ilona; Schmid-Zalaudek, Karin; Lang, Uwe; Schlembach, Dietmar; Cervar-Zivkovic, Mila; Lackner, Helmut Karl.

In: PLoS ONE, Vol. 13, No. 5, e0197748, 01.05.2018.

Research output: Contribution to journalArticleResearchpeer-review

Kolovetsiou-Kreiner, V, Moertl, MG, Papousek, I, Schmid-Zalaudek, K, Lang, U, Schlembach, D, Cervar-Zivkovic, M & Lackner, HK 2018, 'Maternal cardiovascular and endothelial function from first trimester to postpartum' PLoS ONE, vol. 13, no. 5, e0197748. https://doi.org/10.1371/journal.pone.0197748
Kolovetsiou-Kreiner V, Moertl MG, Papousek I, Schmid-Zalaudek K, Lang U, Schlembach D et al. Maternal cardiovascular and endothelial function from first trimester to postpartum. PLoS ONE. 2018 May 1;13(5). e0197748. https://doi.org/10.1371/journal.pone.0197748
Kolovetsiou-Kreiner, Vassiliki ; Moertl, Manfred Georg ; Papousek, Ilona ; Schmid-Zalaudek, Karin ; Lang, Uwe ; Schlembach, Dietmar ; Cervar-Zivkovic, Mila ; Lackner, Helmut Karl. / Maternal cardiovascular and endothelial function from first trimester to postpartum. In: PLoS ONE. 2018 ; Vol. 13, No. 5.
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abstract = "Objective To explore noninvasively the complex interactions of the maternal hemodynamic system throughout pregnancy and the resulting after-effect six weeks postpartum. Methods Eighteen women were tested beginning at the 12th week of gestation at six time-points throughout pregnancy and six weeks postpartum. Heart rate, heart rate variability, blood pressure, pulse transit time (PTT), respiration, and baroreceptor sensitivity were analyzed in resting conditions. Additionally, hemoglobin, asymmetric and symmetric dimethylarginine and Endothelin (ET-1) were obtained. Results Heart rate and sympathovagal balance favoring sympathetic drive increased, the vagal tone and the baroreflex sensitivity decreased during pregnancy. Relative sympathetic drive (sympathovagal balance) reached a maximum at 6 weeks postpartum whereas the other variables did not differ compared to first trimester levels. Postpartum diastolic blood pressure was higher compared to first and second trimester. Pulse transit time and endothelial markers showed no difference throughout gestation. However, opposing variables PTT and asymmetric dimethylarginine (ADMA) were both higher six weeks postpartum. Conclusions The sympathetic up regulation throughout pregnancy goes hand in hand with a decreased baroreflex sensitivity. In the postpartum period, the autonomic nervous system, biochemical endothelial reactions and PTT show significant and opposing changes compared to pregnancy findings, indicating the complex aftermath of the increase of blood volume, the changes in perfusion strategies and blood pressure regulation that occur in pregnancy.",
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