Maternal arterial stiffness in pregnancies affected by Type 1 diabetes mellitus.
OBJECTIVE
There is little information about maternal central haemodynamics and arterial stiffness in pregnancies affected by Type 1 diabetes mellitus. The aim of the current study was to investigate whether maternal arterial stiffness is altered in pregnant women with Type 1 diabetes mellitus compared with women with uncomplicated pregnancies.


METHODS
This was a cross-sectional study involving 37 pregnant women without diabetes and 37 pregnant women with Type 1 diabetes mellitus during the second trimester of pregnancy. Maternal wave reflection (augmentation index) and pulse wave velocity of the carotid-femoral and carotid-radial part of the arterial tree were assessed non-invasively using applanation tonometry.


RESULTS
Pregnant women with normal pregnancies and Type 1 diabetes mellitus had similar augmentation index (3.7 +/- 12.8 vs. 5.1 +/- 12.6%, P = 0.6), even after adjusting for possible confounders. Within the group of diabetic women, augmentation index was associated with duration of diabetes (P = 0.003, r(2) = 0.22) but not with glycated haemoglobin. Pulse wave velocities were similar between the two groups of women (carotid-femoral: 5.6 +/- 0.9 vs. 5.7 +/- 1.1 m/s, P = 0.4; carotid-radial: 7.4 +/- 1.2 vs. 7.8 +/- 1 m/s, P = 0.1). In the diabetic women there was no significant association between the pulse wave velocities and either duration of diabetes or glycated haemoglobin.


CONCLUSIONS
Pregnancy in women with Type 1 diabetes mellitus is not associated with altered maternal systemic arterial stiffness. However, maternal wave reflections increase with the duration of diabetes.
Anderson
J M
JM
Harris Birthright Research Centre for Fetal Medicine, King's College Hospital, London, UK.
Savvidou
M D
MD
Kaihura
C
C
McEniery
C M
CM
Nicolaides
K H
KH
D000328:Adult; D002339:Carotid Arteries / Q000503:physiopathology*; D003430:Cross-Sectional Studies; D003922:Diabetes Mellitus, Type 1 / Q000150:complications / Q000503:physiopathology*; D005260:Female; D006439:Hemodynamics / Q000502:physiology*; D006801:Humans; D011247:Pregnancy; D011249:Pregnancy Complications, Cardiovascular / Q000209:etiology / Q000503:physiopathology*; D011262:Pregnancy Trimester, Second; D011254:Pregnancy in Diabetics