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- Title
Obesity in pregnancy causes a volume overload in third trimester.
- Authors
Vonck, Sharona; Lanssens, Dorien; Staelens, Anneleen Simone; Tomsin, Kathleen; Oben, Jolien; Bruckers, Liesbeth; Gyselaers, Wilfried
- Abstract
Background: Obesity is a major risk factor for cardiovascular diseases. In this study, we aimed to investigate the maternal circulatory differences during pregnancy between obese and normal weight women. Materials and methods: The functioning of the maternal circulation (arteries, veins, heart and body fluid) was assessed by ECG‐Doppler ultrasound, impedance cardiography (ICG) and bio‐impedance during pregnancy in obese women (BMI ≥30 kg/m2) and normal weight, nonobese women (BMI 20‐25 kg/m2). In this observational study, 232 assessments were performed in the obese group, whereas 919 assessments were performed in the nonobese group. Results: Relative to nonobese women, the overall cardiovascular function in obese women during first and second trimester is consistent with a high volume/low‐resistance circulation. In third trimester, cardiac output of obese women decreases from 9.2 (8.2‐10.7) L/min to 8.5 (7.6‐9.6) L/min (P = .037) whereas this is not true in the nonobese women (from 7.8 (7‐8.5) L/min to 7.8 (6.8‐8.9) L/min, P = .536). Simultaneously, the persistently lower peripheral vascular resistance in obese vs nonobese women disappears (880 (761‐1060) dyn.sec/cm5 vs 928 (780‐1067). Conclusions: The circulatory gestational adaptations between nonobese and obese women were generally similar. The findings in the third trimester suggest that a pregnancy in obese women start as a state of high volume/low resistance, gradually shifting to a volume overload with decrease of cardiac output and disappearance of low vascular resistance. This evolution makes obese women vulnerable for gestational hypertensive diseases.
- Subjects
VASCULAR resistance; BODY fluids; DISEASE risk factors; PREGNANCY; CARDIAC output
- Publication
European Journal of Clinical Investigation, 2019, Vol 49, Issue 11, pN.PAG
- ISSN
0014-2972
- Publication type
Article
- DOI
10.1111/eci.13173