The feasibility of prospectively studying maternal cardiovascular changes from before conception
The feasibility of prospectively studying maternal cardiovascular changes from before conception
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前瞻性研究受孕前母亲心血管变化的可行性
DOI：
10.1038/hr.2013.24
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发表时间：
2013
影响因子：
5.4
通讯作者：
C. Lees
中科院分区：
文献类型：
--
作者：
A. Mahendru;T. Everett;C. McEniery;I. Wilkinson;C. Lees
有令人信服的证据表明，怀孕前和植入前后的因素可能对母体心血管适应怀孕和随后的妊娠结局有影响。妊娠前的前瞻性研究与招募困难、低受孕率、早孕丢失以及妊娠期间和产后随访参与者的保留率低有关。本研究的目的是确定招募、开展和完成一项从孕前至产后的前瞻性队列研究的可行性。招募了143名计划怀孕的妇女。他们接受了详细的心血管测量，包括肱动脉和中心血压，心输出量，主动脉僵硬度和脉搏波反射，代谢功能和血小板聚集。一旦怀孕，在整个怀孕期间和产后定期重复心血管评估。在143名妇女中，101名妇女在18个月内怀孕。71例在10 - 14周时妊娠。在70例活产婴儿中，3例妇女发生先兆子痫（PE），2例发生宫内生长受限。2例失访。招募计划怀孕的妇女，进行孕前心血管评估并在怀孕期间对其进行随访是可行的。根据目前的数据，大约一半的妇女将有健康的持续怀孕。这些信息将允许设计一项研究，为妊娠并发症（如PE）提供动力，以调查心血管功能异常与妊娠并发症之间的"因果关系"。
There is compelling evidence that factors before pregnancy and around implantation may have a bearing on maternal cardiovascular adaptation to pregnancy and subsequent pregnancy outcome. Prospective studies from before pregnancy are associated with difficulties in recruitment, low conception rates, early pregnancy loss and low retention of participants during pregnancy and postpartum follow-up. The objective of this study was to establish the feasibility of recruiting to; conducting and completing a prospective cohort study from before pregnancy to the postpartum period. One-hundred and forty-three women planning to conceive were recruited. They underwent detailed cardiovascular measurements including brachial and central blood pressures, cardiac output, aortic stiffness and pulse wave reflection, metabolic function and platelet aggregation. Once pregnant, the cardiovascular assessments were repeated at intervals throughout pregnancy and postpartum. Of 143 women, 101 women conceived within 18 months. Seventy-one had viable pregnancies at 10–14 weeks. Among the 70 live-births, three women developed preeclampsia (PE) and two had intrauterine growth restriction. Two were lost to follow-up. It is feasible to recruit women who are planning to conceive, conduct prepregnancy cardiovascular assessments and follow them up during pregnancy. Based on the current data, approximately half the women recruited will have healthy ongoing pregnancies. This information would allow the design of a study, powered for pregnancy complications such as PE, to enable investigation of the ‘cause and effect’ relationship between abnormal cardiovascular function and pregnancy complications.
影响因子：
19.6
作者：
Chapman, AB;Abraham, WT;Schrier, RW
通讯作者：
Schrier, RW
影响因子：
158.5
作者：
Wilcox, AJ;Baird, DD;Wenberg, CR
通讯作者：
Wenberg, CR