81 Does maternal obesity have an adverse effect on haemodynamics?

Abstract

Background Obesity is a global epidemic, which is associated with increased perinatal mortality and morbidity. Despite the significant health and economic impact of maternal obesity, there is a paucity of good quality studies assessing central haemodynamic parameters in morbidly obese pregnant women. Objective To investigate the haemodynamic profile in women with morbid obesity, defined as body mass index (BMI) greater than 40 kg/m2, in the absence of hypertensive disorders of pregnancy. Methods A prospective, case-control study of 23 pregnant women with class 3 obesity and 327 controls with a normal BMI, matched for maternal age and gestational age. We planned to recruit 10 control cases for each obese case. Women aged 16 and over with singleton pregnancies of 12 or more weeks’ gestation were recruited from routine antenatal scanning clinics and the maternity day assessment unit at our tertiary centre. Those found to be hypertensive at the time of study recruitment, had a pre-existing diagnosis of hypertensive disorders of pregnancy (ISSHP 2014) or congenital/acquired heart disease, were not included in the analysis. Maternal haemodynamics were investigated using Ultrasound Cardiac Output Monitor (USCOM 1A®). All non-invasive assessments were performed in the same room, under standardised conditions for the entire cohort. Mann Whitney U test, Chi-Square test, or Fisher’s exact test when appropriate, was used to compare the categorical variables between the two groups. Results Women with morbid obesity had raised mean arterial pressure (91 vs 85 mmHg, p Conclusions Morbidly obese pregnant women have an adverse haemodynamic profile compared to women of normal weight, even in women who did not develop hypertensive disorders of pregnancy. The abnormal haemodynamics observed in obesity are consistent with findings outside of pregnancy and with the predisposition of obese women to hypertensive disorders of pregnancy. Given the differences in anthropometric parameters.