title: Measurement of aortic augmentation index in pregnant women with raised blood pressure and subsequent outcomes: a preliminary prospective cohort study.
abstract: OBJECTIVE
  Preeclampsia is associated with arterial dysfunction and augmentation index (AIX%) is an established indicator of arterial dysfunction. Our aim was to investigate the relationship of AIX% with time-to-delivery and other outcomes in women admitted to an antenatal triage unit.
  
  
  METHODS
  We recruited 28 women with singleton pregnancies attending antenatal triage ward for assessment of hypertension. After 10 min rest, seated brachial blood pressure (Omron HEM-757) and AIX% (SphygmoCor applanation tonometry pulse wave analysis, PWA) were measured by a single investigator; other clinicians remained blinded to PWA results. Routine assessment included cardiotocography, urine analysis and blood tests. Subsequent outcomes were extracted from the obstetric records.
  
  
  RESULTS
  Mean AIX% was 19.7% (SD 11.5; range -4% to +36%), maternal age 31 years, gestation 37 weeks, brachial BP 145/95, proteinuria 39%. Nine women had preeclampsia at assessment and six subsequently developed preeclampsia. Median time-to-delivery was 10 d (IQR 1.6-25 d) and was shorter for AIX% ≥ 20% (median 8.9 versus 19.8 d). AIX% was higher with preeclampsia (24.0%; SD 9.5) versus gestational hypertension (15.2%; SD 12.4); absolute difference 8.8% (95%CI 0.1-17.5; p = 0.05). A one-point higher AIX% (adjusted for age, urate and gestation) was associated with 0.3 d (95%CI -0.5 to 0.0; p = 0.06) reduced time-to-delivery. A higher AIX% was also associated with induction for preeclampsia, severe preeclampsia, peripartum-anti-hypertensives and discharge-on-anti-hypertensives. Area under the curve (AUC) for AIX% predicting preeclampsia was 0.80 (95%CI 0.59-1.00; p = 0.04).
  
  
  CONCLUSIONS
  AIX% is associated with time-to-delivery and other outcomes in pregnancy.
authors: Department of Obstetrics, Aberdeen Maternity Hospital , Foresterhill, Aberdeen , UK and.
authors: Gail
authors: G
authors: Fullerton
authors: Michael A
authors: MA
authors: Crilly
authors: Sohinee
authors: S
authors: Bhattacharya
authors: Peter J
authors: PJ
authors: Danielian
mesh_terms: D000328:Adult; D001011:Aorta / Q000503:physiopathology*; D003935:Diagnostic Techniques, Cardiovascular; D005260:Female; D006801:Humans; D046110:Hypertension, Pregnancy-Induced / Q000175:diagnosis / Q000503:physiopathology*; D011247:Pregnancy; D011256:Pregnancy Outcome; D011446:Prospective Studies
keywords: Applanation tonometry; Augmentation index; Hypertension; Preeclampsia; Pregnancy; Pulse wave analysis.