EP02.09: Evaluation of cardiovascular function in women with a history of pre‐eclampsia: a systematic review and meta‐analysis

To determine whether women with a history of pre-eclampsia show clinical or subclinical cardiovascular changes when evaluated by echocardiography. A systematic search of MEDLINE, EMBASE and CINAHL databases was performed from inception to December 2018. Studies that examined cardiovascular function in women with a history of pre-eclampsia, in comparison to those with a history of normotensive pregnancies were included in this review. The cardiac indices assessed included left ventricular mass index, relative wall thickness, left ventricular ejection fraction, mean E/A ratio, mean E/e' ratio, isovolumetric relaxation time, and deceleration time. In the 27 included studies, there was significant heterogeneity in the outcome measures and varying quality between studies. We found no statistically significant differences between exposed and non-exposed women with regards to left ventricular ejection fraction, isovolumetric relaxation time or deceleration time. Women with a history of pre-eclampsia demonstrated a higher left ventricular mass index and relative wall thickness with a mean difference of 4.25g/m2 (95%CI 2.08, 6.42) and 0.03 (95%CI 0.01, 0.05) respectively. In comparison to the non-exposed population they also demonstrated a lower E/A and a higher E/e' ratio with a mean difference of -0.08 (95%CI -0.15, -0.01) and 0.84 (95%CI 0.41, 1.27) respectively. In comparison to women who had a normotensive pregnancy, women with a history of pre-eclampsia show a trend towards altered cardiac structure and function. Further research with larger sample sizes, consistent reporting and assessment of sensitive pre-clinical markers such as myocardial deformation are required in order to clarify these findings. Please note: The publisher is not responsible for the content or functionality of any supporting information supplied by the authors. Any queries (other than missing content) should be directed to the corresponding author for the article.