Brachial And Aortic Blood Pressure Soon After Delivery In Women With Versus Without A Past Adverse Pregnancy Outcome

Abstract

PURPOSE: Adverse pregnancy outcomes (APOs), such as preterm birth, gestational diabetes, and hypertensive disorders of pregnancy, are associated with excess maternal risk of hypertension and cardiovascular disease years later. Little is known about the effect of an APO on aortic blood pressure (BP) in the first few years after delivery. Our purpose was to test the hypothesis that women with a history of APO would have higher peripheral and aortic BP in the 6 months- 3 years after delivery. METHODS: We recruited 37 women aged 18-45 years (26 white/9 black /2 other), from the greater Columbia, SC area who delivered a singleton infant 6 months - 3 years ago to participate in our study. Women were excluded if they were smokers, had diabetes, HIV/AIDS, or were receiving cancer therapy. Participants completed a single visit following an overnight fast during which brachial and aortic BP were measured using an oscillometric cuff and applanation tonometry, respectively. History of APO and sociodemographic information were determined via self-report. After assessing the distribution of the data with Shapiro-Wilk tests, we tested for differences in brachial and aortic systolic, diastolic, and mean BP between groups using t-tests or Kruskal-Wallis tests, as appropriate. RESULTS: Mean age was 33±1 yrs and mean BMI was 26.6±1.0 kg/m2 with no difference between groups. Of the 37 women in the study, 12 had a history of APO with no difference in race distribution by group. Mean brachial and aortic systolic BP tended to be higher in women with a history of APO: 116±4 versus 108±3 mmHg, p=0.07 (brachial) and 105±4 versus 97±1 mmHg, p=0.08 (aortic). There was no difference in brachial or aortic diastolic or mean BP between groups. CONCLUSIONS: Women with a history of APO tended to have higher peripheral and aortic systolic BP 6 months- 3years after delivery. The effects of an APO on BP may be detectable soon after the pregnancy ends and might represent a target for prevention of overt cardiovascular disease in affected women.