Oral Presentation Society of Obstetric Medicine of Australia and New Zealand ASM 2023

Assessment of markers of vascular stiffness in women with and without metabolic syndrome who have experienced a major pregnancy complication: an observational cohort study (#24)

Stevie Young 1 2 3 , Maleesa Pathirana 2 3 4 , Alison Care 3 , Emily Aldridge 2 3 4 , Margaret Arstall 4 5 , Gustaaf Dekker 2 3
  1. University of Adelaide, Faculty of Health and Medical Sciences , SA
  2. Obstetrics and Gynaecology , Lyell McEwin Hospital, Elizabeth Vale
  3. Robinson Research Institute and Faulty of Health and Medical Sciences, University of Adelaide, Adelaide
  4. Cardiology, Lyell McEwin Hospital , Elizabeth Vale
  5. Faculty of Health and Medical Sciences, University of Adelaide, Adelaide

Background:

Young Australian women continue to be affected by cardiovascular disease disproportionally to their male counterparts. Women who experience pregnancy complications including hypertensive disorders of pregnancy (HDP), gestational diabetes mellitus (GDM), placental abruption, spontaneous preterm delivery (sPTB), or intrauterine growth restructure (IUGR) are at increased risk of cardiovascular disease and mortality. However, little is known about the vascular health of women who experience a complication of pregnancy and go on to develop post-partum metabolic syndrome (MetS). Our primary aim is to assess differences between novel markers of vascular stiffness in women who had a complicated pregnancy with MetS 6 months postpartum and those who do not have MetS.

 Methods:

A total of 478 women who had experienced a complication of pregnancy such as HDP, GDM, and placental abruption, sPTB or IUGR were assessed 6 months post-partum as part of the Cardiovascular Assessment after Obstetric Complications: Follow Up for Education and Evaluation (COFFEE) Clinic at the Lyell McEwin Hospital. Metabolic syndrome (MetS) was defined as the Harmonising the Metabolic Syndrome definition. Information was collected on demographics, medical and obstetric history. Markers of vascular function (central systolic/diastolic blood pressure, mean arterial pressure, pulse wave velocity, augmentation index and pulse rate) were assessed with the USCOM BP+. Ethics was approved by Central Adelaide Local Health Network (HREC/16/TQEH/258).

 Results:

Women with MetS at 6 months post-partum were more socioeconomically disadvantaged than those who did not have MetS (992.12 ± 83.2 vs. 935.12 ± 73.5, p = 0.041). These women were also more likely to have experienced GDM (n=114 (76%) vs. n=161 (59%), p = 0.000). Additionally, they had been exposed to cigarette smoke, either through being a smoker (n=22 (14.9%) vs. n=22 (8.1%), p= 0.038) or second hand (n= 34 (22.7%) vs. n= 39 (14.3%) p= 0.030) Women with MetS at 6 months post-partum had a higher pulse rate (78bpm ± 12 vs.74bpm ± 10, p= 0.020).

 Conclusion:

The findings of this study suggest that non-invasive markers of cardiovascular stiffness require further research before they are applicable for use in predicting increased cardiovascular risk in women who have experienced a complication of pregnancy, as both groups of this study being compared are very similar. Additionally, further research is needed into GDM as a specific risk factor for future cardiovascular disease, as well as how exposure to cigarette smoke in the post-partum period affects a woman’s likelihood of developing MetS.