Cardiodynamic Profiles of Gravidas with Obesity in Early Gestation

Abstract

Background Obesity is a significant contributor to adverse maternal and perinatal outcomes, increasing the risk of spontaneous miscarriage, stillbirth, preterm delivery, fetal malformations, gestational diabetes, fetal macrosomia, cesarean section, maternal thromboembolic complications, and hypertensive complications. Historical data indicate that nonpregnant individuals with obesity typically have an elevated cardiac output, increase in total and central blood volume, and low peripheral vascular resistance. Studies measuring hemodynamic parameters in pregnant patients with obesity is lacking. Methods A retrospective study was conducted in 796 pregnant patients referred to the Maternal Hypertension Center at Cabell Huntington Hospital; 335 had a Body Mass Index (BMI) of < 30kg/m2, 171 had a BMI of 30kg/m2 - 34.9kg/m2, 154 had a BMI of 35kg/m2 - 39.9kg/m2, and 136 had a BMI >4 40kg/m2. Results The maternal hemodynamic parameters showed significant differences in systolic blood pressure (p value <.01), mean arterial pressure (p value = 0.01), cardiac output (p value <0.01), and systemic vascular resistance (p value <0.01). There were no significant differences in maternal heart rate (p value = 0.2093) or diastolic blood pressure between groups (p value = 0.1139). Conclusion Non-invasive hemodynamic testing offers the opportunity to further explore pathologic cardiovascular alterations of pregnant patients with obesity. Further research is needed to categorize hemodynamic parameters, with an attempt to explore potential interventions to improve pregnancy outcomes for gravidas with obesity.