Postpartum maternal cardiac adaptation in smallness-for-gestational age (SGA) pregnancies and its correlation with biomarkers of cardiovascular risk

Objective. To evaluate in women at high risk for placental insufficiency maternal cardiac geometry adaptation from the early-third trimester to 6 months postpartum (6MPP), by the occurrence of smallness-for-gestational age (SGA), and to as­sess the correlation between the maternal cardiac adaptation and cardiovascular biomarkers.
Materials and Methods. A high-risk placental insufficiency cohort was prospectively evaluated at 28 weeks and 6MPP us­ing echocardiography. Structural cardiac parameters included left atrium (LA) and ventricle (LV) volumes, and septum and posterior LV wall thickness. Cardiovascular risk biomarkers were collected at 6 MPP including a lipidic profile, VCAM-1, and NT-proBNP. SGA was defined as birthweight < 10th centile (local curves).
Delta values (28 weeks ‒ 6 MPP) were compared by quantile regression between SGA and AGA, adjusted by maternal BMI. Spearman correlation was performed between cardiac mor­phometry changes and biomarkers.
Results. 62.3% women were initially nulliparous. Mean ma­ternal age was 35.6 years (SD 4.6).
No significant differences were found in LA and LV volumes between groups. SGA pregnancies had significantly lower BMI-adjusted delta values of the septum thickness (-0.06 vs 0.07 mm; p = 0.003), LV posterior wall thickness (-0.078 vs 0.138 mm; p = 0.026), and LV mass (-3.55 vs 27.81 g; p = 0.002). LV poste­rior wall thickness at 6 MPP was negatively and significantly correlated with HDL and Apolipoprotein A1 levels whereas a positive significant correlation was found with TG/HDL ratio.
Conclusions. SGA pregnancies exhibited at 6 months postpar­tum increased LV posterior wall and septum thicknesses, and this finding correlated with an impaired lipid and atherogenic profile.