The cardiovascular changes in the first trimester in advanced maternal-aged women

Advanced maternal age (AMA) is defined as 35 years or above at delivery and is an increasing trend worldwide. In 2017, 18.3% of women giving birth in the US were AMA. AMA is associated with various pregnancy-related pathologies contributing to maternal mortality and morbidity. We aimed to investigate maternal cardiovascular differences in the first trimester in AMA women compared with younger women using USCOM® (Ultrasound Cardiac Output Monitor), a non-invasive and quantitative method. A prospective observational study of women with singleton pregnancy enrolled in prenatal care at a University of Miami clinic between January 2022 and July 2022. Pregnant women with a history of preexisting severe cardiorespiratory disease or congenital heart defect affecting cardiac function and taking Aspirin were excluded. Comprehensive cardiovascular parameters via USCOM® were obtained. Patients were divided into the advanced maternal-aged group (age ≥ 35) and the younger group (age < 35). Data were analyzed by independent t-test for parametric continuous data, Mann-Whitney U test for non-parametric data, and Chi-square test for categorical data. P < .05 was considered statistically significant. Doppler waveforms for analysis were achieved for 48 women among 57 participants. Basic characteristics are not significantly different between the two groups except maternal age at inclusion and the prevalence of preexisting chronic hypertension. Women with AMA had higher Systemic Vascular Resistance (SVR), Systemic Vascular Resistance Index (SVRI), whereas they had lower Peak Velocity (PV), Velocity Time Integral (VTI), Mean Pressure Gradient (MPG), and Cardiac Index (CI). Flow time Corrected (FTc), Ejection Time percentage (ET%), and Inotropy Index (II) are not different between groups. We found different mechanisms in the advanced maternal-aged group. Our results showed that pregnant women with AMA may already have established a hidden process of aging-related vascular dysfunction and aortic valve stiffening instead of reduced cardiac function.View Large Image Figure ViewerDownload Hi-res image Download (PPT)