The influence of high maternal body mass index (≥35 kg/m²) on haemodynamic parameters during pregnancy: a prospective observational study.

IF 1.2 4区医学 Q4 OBSTETRICS & GYNECOLOGY

Journal of Obstetrics and Gynaecology Pub Date : 2025-12-01 Epub Date: 2025-09-05 DOI:10.1080/01443615.2025.2552408

Majedah Hmeidan, Francesca M T Leone, Mohammed W Osman, David Webb, Hatem A Mousa

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引用次数: 0

Abstract

Background: Maternal obesity is a growing global health concern, yet its impact on maternal haemodynamic throughout pregnancy remains underexplored. We investigated haemodynamic adaptations across gestation in women with high body mass index (BMI) (≥35 kg/m²) and results were compared to low-risk controls (BMI 18.5-24.9 kg/m²).

Methods: This prospective observational study used non-invasive cardiac output monitoring (NICOM; Baxter Healthcare, Deerfield, IL) to assess maternal haemodynamic parameters, including cardiac output (CO), stroke volume (SV), total peripheral resistance (TPR), systolic blood pressure (sBP) and mean arterial pressure (MAP) in pregnant women with high BMI. Assessments were carried out across five gestational windows (11-19 + 6, 20-27 + 6, 28-33 + 6, 34-37 + 6 and ≥38 weeks). Results were compared to low-risk healthy controls (BMI 18.5-24.9 kg/m²).

Results: A total of 329 women were recruited, including 125 with high BMI and 189 controls. Across all gestational windows, women with high BMI consistently demonstrated significantly higher CO and SV. Compared to controls, median CO was high among women with high BMI, at 11-19 + 6 weeks [8.8 L/min (IQR 7.2-9.9) versus 6.7 L/min (5.8-7.6); p < .001]; median SV was 104.2 mL (93.7-124.9) versus 81.9 mL (74.3-94.0) (p < .001). This trend persisted at later gestations. In contrast, median TPR was significantly lower in the high BMI group; at 28-33 + 6 weeks, 847 dyn·s·cm^-5 (unit of measurement of TPR: dynes·seconds per centimetre to the fifth power) (783-937) versus 1083 (924-1161) in the controls (p < .001). Despite reduced TPR, sBP and MAP were higher in women with high BMI throughout pregnancy. Heart rate (HR) and diastolic blood pressure (dBP) did not differ significantly between groups at any gestational window.

Conclusions: Pregnant women with high BMI have a distinctive haemodynamic profile characterised by high CO with a compensatory reduction in TPR. Further research is required to assess the risk of placental mediated diseases in that group.

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孕妇高体重指数（≥35 kg/m2）对妊娠期血流动力学参数的影响：一项前瞻性观察研究

背景：孕产妇肥胖是一个日益严重的全球健康问题，但其对妊娠期间孕产妇血流动力学的影响仍未得到充分探讨。我们调查了高体重指数（BMI）（≥35 kg/m2）妇女妊娠期间的血流动力学适应，并将结果与低风险对照组（BMI 18.5-24.9 kg/m2）进行比较。方法：本前瞻性观察研究采用无创心输出量监测（NICOM; Baxter Healthcare, Deerfield， IL）来评估高BMI孕妇的血流动力学参数，包括心输出量（CO）、卒中容积（SV）、总外周阻力（TPR）、收缩压（sBP）和平均动脉压（MAP）。评估分5个妊娠期窗（11-19 + 6周、20-27 + 6周、28-33 + 6周、34-37 + 6周和≥38周）进行。结果与低风险健康对照组（BMI 18.5-24.9 kg/m2）进行比较。结果：共招募了329名女性，其中125名BMI高，189名对照组。在所有妊娠期，高BMI的女性均表现出明显较高的CO和SV。与对照组相比，高BMI的女性在11-19 + 6周时的CO中位数较高[8.8 L/min （IQR 7.2-9.9）对6.7 L/min (5.8-7.6)；p p -5 （TPR的测量单位：达因·秒每厘米的五次方）（783-937）与对照组的1083（924-1161）相比(p结论：高BMI的孕妇具有独特的血流动力学特征，其特征是高CO伴TPR代偿性降低。需要进一步的研究来评估该群体中胎盘介导疾病的风险。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Obstetrics and Gynaecology 医学-妇产科学

CiteScore

2.40

自引率

7.70%

发文量

398

审稿时长

6 months

期刊介绍： Journal of Obstetrics and Gynaecology represents an established forum for the entire field of obstetrics and gynaecology, publishing a broad range of original, peer-reviewed papers, from scientific and clinical research to reviews relevant to practice. It also includes occasional supplements on clinical symposia. The journal is read widely by trainees in our specialty and we acknowledge a major role in education in Obstetrics and Gynaecology. Past and present editors have recognized the difficulties that junior doctors encounter in achieving their first publications and spend time advising authors during their initial attempts at submission. The journal continues to attract a world-wide readership thanks to the emphasis on practical applicability and its excellent record of drawing on an international base of authors.