376 Maternal age impact on hemodynamic monitoring at delivery evaluated by a novel non-invasive PPG-based sensor

Abstract

Age influence maternal hemodynamics and adaptation during labor and delivery. We utilized an innovative, noninvasive, reflective PPG-based device (Biobeat Technologies Ltd.) that enables continuous monitoring to assess cardiovascular changes during labor and delivery stratified by maternal age. The Biobeat Monitoring Platform includes a wearable wristwatch monitor, that automatically samples cardiac output (CO), blood pressure (BP), stroke volume (SV), systemic vascular resistance (SVR) and heart rate (HR) every 5 seconds and uploads all data to a smartphone-based app and to a data cloud, enabling remote monitoring and analysis of data. Low risk parturients carrying term, singletons pregnancies were recruited at early delivery. Big data analysis was performed using the Power BI analysis tool (Microsoft). Data was normalized to visual presentation using Excel Data Analysis and regression tool. Average measurements were compared 20 minutes before and after epidural anesthesia and fetal delivery, stratified by maternal age. 81 parturients were recruited (26 nullipara; BMI 29.7±5.1,Kg/m2) and allocated to study (≥ 35 years, 17/81, 21%, mean age 36.7±2) and control group (<35 years, 64/81, 79%, mean age 28.6±3.2). Over 800,000 measurements were retrieved. During labor and around epidural anesthesia study group had lower CO, SV and HR values. MAP was also lower despite higher SVR values (for example: mean CO 5.1 to 5 for study group vs. 5.5 to 5.6 for control group, L/min, 20 minutes before and after epidural, p<0.05 for all, Fig 1). Same trend continued at delivery with lower CO, HR, SVR, MAP and higher SVR values for study group (for example: mean CO 5.9 to 6.8 to 5.8 for study group vs. mean CO 6.1 to 7.3 to 6.5 for control group, L/min, 20 minutes before, at peak and after delivery, p<0.05 for all, Fig 2). Both epidural and delivery were associated with statistical significant changes for most parameters, however, not all differences had clinical significance. Maternal age influences hemodynamic adaptation during labor and delivery.View Large Image Figure ViewerDownload Hi-res image Download (PPT)