Mechanical Properties of Large Arteries in Mother and Fetus during Normal and Diabetic Pregnancy.

Abstract

> Objective: To assess the influence of diabetes mellitus on the mechanical wall properties of large maternal and fetal arteries in pregnant women. Methods: Prospective serial monitoring of arterial wall characteristics, using ultrasonic phase-locked tracking of vessel diameters and oscillometric brachial blood pressure measurements. Ten pregnant women with insulin-dependent diabetes mellitus and 15 with gestational diabetes were studied and compared with 20 women in uncomplicated gestation. Results: In women with uncomplicated pregnancy, the stiffness index and the elastic modulus of the maternal aorta were lower (both P < 0.05), whereas the pulse amplitude and the strain were higher (both P < 0.05) in the 12th gestational week than in the 6th week postpartum. These differences did not appear in pregnancy complicated by insulin-dependent diabetes. In early gestation, higher aortic stiffness index and elastic modulus (both P < 0.05) and lower pulse amplitude and strain (both P < 0.05) were recorded in gravidae with insulin-dependent diabetes compared with nondiabetic pregnant women; those with gestational diabetes were not detected in early pregnancy. No intergroup or intragroup differences of stiffness index and pulse amplitude were found in the carotid artery in corresponding gestational ages. In the fetal aorta, the pulse wave velocity increased during the third trimester of normal gestation (P < 0.05) but not in insulin-dependent diabetic pregnancy. Conclusion: The difference found concerning the aortic stiffness between women with insulin-dependent diabetes during pregnancy and those with uncomplicated pregnancy might be interpreted as an altered cardiovascular adaptation to pregnancy in women with diabetes.