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首页> 外文期刊>Pregnancy hypertension >Cardiac remodeling in morbidly obese women and its association with adverse perinatal outcomes
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Cardiac remodeling in morbidly obese women and its association with adverse perinatal outcomes

机译：在病态肥胖妇女的心脏重塑及其与不良围产期结果的关联

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Objectives: To determine the association of cardiac remodeling in early pregnancy and adverse perinatal outcomes among women with BMI > 40 kg/m2. Study design: We performed a retrospective cohort study including women with BMI > 40 kg/m2 without known cardiac disease. Women who underwent screening transthoracic echocardiography prior to gestational age 24 weeks were included. Women were analyzed by group with normal or abnormal geometry, including concentric remodeling, eccentric hypertrophy, and concentric hypertrophy. Multivariable logistic regression was used to assess the association of abnormal geometry with perinatal outcomes. We had 80% power with alpha 0.05 to detect a 3.0-fold increase in the primary outcome among women with abnormal geometry. Main outcome measures: Our primary outcome was a composite of adverse perinatal outcomes including any 1 of the following: preterm birth (< 37 weeks), low birth weight (< 2500 g), or hypertensive disorders of pregnancy, including gestational hypertension, preeclampsia, and chronic hypertension with superimposed preeclampsia. Results: Of 140 women, 53 (37.9%) had abnormal geometry. The average BMI was similar between those with normal and abnormal geometry (44.7 vs. 44.2 kg/m2, p = 0.53). The primary outcome occurred in 20.7% with normal geometry and 30.2% with abnormal geometry (p = 0.20). After adjustment for parity, chronic hypertension, and tobacco use, abnormal cardiac geometry was not associated with the composite primary outcome (adjusted OR 2.01 [95% CI 0.84-4.78]) but was associated with hypertensive disorders of pregnancy (adjusted OR 2.82 [95% CI 1.03-7.78]). Conclusions: Cardiac remodeling early in pregnancy is associated with hypertensive disorders of pregnancy.
机译：目的：确定妊娠早期心脏重塑的关联，女性患有BMI> 40kg / m2的妇女的不良围产后。研究设计：我们进行了一种回顾性队列研究，包括BMI> 40kg / m2的女性，没有已知的心脏病。包括在24周之前接受筛查妊娠期超声心动图的妇女。通过具有正常或异常的几何形状分析妇女，包括同心重塑，偏心肥大和同心肥大。多变量逻辑回归用于评估异常几何与围产期结果的关联。我们有80％的功率，alpha 0.05，检测具有异常几何形状的女性的主要结果增加3.0倍。主要结果措施：我们的主要结果是不良围产期结果的复合材料，其中包括以下任一项：早产（<37周），低出生体重（<2500g）或妊娠高血压障碍，包括妊娠期高血压，Preclampsia，和慢性高血压与叠加的预液柱。结果：140名女性，53名（37.9％）几何形状异常。平均BMI之间的几何和异常几何形状（44.7与44.2kg / m 2，p = 0.53）之间相似。主要结果发生在20.7％，正常几何形状，几何形状异常，30.2％（P = 0.20）。在调整奇偶校验后，慢性高血压和烟草使用，异常心脏几何形状与复合主要结果无关（调节或2.01 [95％CI 0.84-4.78]），但与妊娠高血压障碍有关（调整或2.82 [95] ％ci 1.03-7.78]）。结论：怀孕早期的心脏重塑与怀孕高血压障碍有关。

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