Abstract 10533: Greater Left Ventricular Mass And Abnormal Diastolic Myocardial Function In Neonates Of Pre-eclamptic Pregnancies

Abstract

Introduction: Maternal pre-eclampsia (PEC) is a placental insufficiency syndrome with potential effects on neonatal cardiac function. Hypothesis: We tested the hypothesis that neonatal exposure to maternal PEC results in systolic and diastolic myocardial dysfunction on echocardiogram. Methods: Neonates exposed to maternal PEC (N=142) were matched 1:1 for gestational age and gender (N=142) with neonates concurrently enrolled in our center during the same study period (2009-2019). Echocardiograms performed in first 30 days of life were analyzed. Image analysis was done retrospectively and included LV and RV global peak longitudinal strain, mitral and tricuspid inflow and tissue Doppler, and LV mass indexed to body surface area. Analyses included two-sample t-test, Wilcoxon rank sum, chi-squared, and Bonferroni correction testing. Results: The average gestational age was 28 weeks, with slight male predominance of 54.9%. Birth weight was 885g in PEC group, compared to 1100g in the control (p=0.003). Median age at echocardiogram was 8 days for PEC and 6 days for control.In the PEC group, systolic function demonstrated decreased longitudinal 2-chamber average peak strain and higher mean LV mass. There was no difference in 4-chamber average peak strain, circumferential mid-LV average peak strain, or longitudinal RV 6-segment average strain. Mitral and tricuspid valve E-wave deceleration times were shorter in the PEC group. There were no differences in other markers of diastolic function, including E/A and E/e’ ratio. Conclusions: PEC neonates have increased RV and LV stiffness, indicated by reduced E-wave deceleration time of the mitral and tricuspid valves. This is suggestive of grade 2 diastolic dysfunction. LV mass was increased in the PEC group. We did not find compelling evidence of systolic dysfunction with strain analysis. In conclusion, maternal PEC exposure results in neonatal diastolic abnormalities that may have long term effects on cardiac function.