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Title: Obesity in pregnancy causes a volume overload in third trimester
Authors: VONCK, Sharona 
STAELENS, Anneleen 
TOMSIN, Kathleen 
OBEN, Jolien 
BRUCKERS, Liesbeth 
GYSELAERS, Wilfried 
Issue Date: 2019
Publisher: WILEY
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/m(2)) and normal weight, nonobese women (BMI 20-25 kg/m(2)). 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/cm(5) 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.
Notes: [Vonck, Sharona; Lanssens, Dorien; Gyselaers, Wilfried] Hasselt Univ, Fac Med & Life Sci, Agoralaan, Diepenbeek, Belgium. [Vonck, Sharona; Lanssens, Dorien; Staelens, Anneleen Simone; Tomsin, Kathleen; Oben, Jolien; Gyselaers, Wilfried] Ziekenhuis Oost Limburg, Dept Obstet & Gynaecol, Schiepse Bos 6, B-3600 Genk, Belgium. [Gyselaers, Wilfried] Hasselt Univ, Dept Physiol, Diepenbeek, Belgium. [Bruckers, Liesbeth] Hasselt Univ, Interuniv Inst Biostat & Stat Bioinformat, Diepenbeek, Belgium.
Keywords: circulation; maternal haemodynamics; obesity; physiology; pregnancy;circulation; maternal haemodynamics; obesity; physiology; pregnancy
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ISSN: 0014-2972
e-ISSN: 1365-2362
DOI: 10.1111/eci.13173
ISI #: 000490040600001
Rights: 2019 Stichting European Society for Clinical Investigation Journal Foundation
Category: A1
Type: Journal Contribution
Validations: ecoom 2020
Appears in Collections:Research publications

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