Fetal growth retardation and hemorheological predictors of oxygen delivery in hypertensive vs normotensive pregnant women

Issue title: SPECIAL SECTION: Selected Papers of the Joint Conference of the ESCHM-ISCH-ISB-2018, 2-6 July, 2018, Krakow, Poland

Article type: Research Article

Authors: Brun, Jean-Frédéric^{a; *} | Varlet-Marie, Emmanuelle^{b; c} | Boulot, Pierre^d | Marion, Bénédicte^{b; c} | Roques, Céline^{b; c} | Mercier, Jacques^a | Raynaud de Mauverger, Eric^a

Affiliations: [a] U1046 INSERM, UMR 9214 CNRS « Physiopathologie & Médecine Expérimentale du Cœur et des Muscles - PHYMEDEXP », Unité d’Explorations Métaboliques (CERAMM), Université de Montpellier, Département de Physiologie Clinique, Hôpital Lapeyronie CHRU Montpellier, France | [b] Institut des Biomolécules Max Mousseron (IBMM) UMR 5247 CNRS, Université de Montpellier, Ecole Nationale Supérieure de Chimie de Montpellier, France | [c] Laboratoire de Biophysique & Bio-Analyses, Faculté de Pharmacie, Université de Montpellier, France | [d] Centre Hospitalier Régional Universitaire CHRU de Montpellier, Université de Montpellier, Faculté de Médecine, Department de Gynécologie et Obstétrique, Montpellier, France

Correspondence: [*] Corresponding author: Jean-Frédéric Brun, U1046 INSERM, UMR 9214 CNRS « Physiopathologie & Médecine Expérimentale du Cœur et des Muscles - PHYMEDEXP », Unité d’Explorations Métaboliques (CERAMM), Université de Montpellier, Département de Physiologie Clinique, Hôpital Lapeyronie CHRU Montpellier, France. E-mail: j-brun@chu-montpellier.fr.

Abstract: Physiological modifications of blood rheology during pregnancy and their alterations in pregnant hypertensive women have been extensively studied in the 1980’s. Since vascular resistance is higher in hypertensive pregnant women whose newborns are small-for gestational-age (SGA), we investigated in a personal database if growth retardation of newborns is related to the oxygen delivery index (ratio hematocrit/blood viscosity) and to the difference between hematocrit (Hct) and the prediction of its optimal valued based on Quemada’s equation. A sample of 38 hypertensive pregnant women (age 29 yr±1) was compared with 64 controls matched for age and gestational age, studied at 35±1 weeks gestation, extracted from a larger series of 162 pregnant women. On the whole the hypertensive group gave birth to smaller children (p = 0.014). Plasma viscosity correlated with blood pressure (BP) only in hypertensive women (r = 0.403 p < 0.05). The bell-shaped curve of predicted optimal Hct of non hypertensive pregnant women was similar to that of non-pregnant women, but in hypertensive women it was shifted toward higher values (p = 0.07), and the predicted optimal Hct (but not the actual one) was correlated with systolic blood pressure (SBP) (r = 0.349 p < 0.001) and diastolic blood pressure (DBP) (r = 0.218 p < 0.05). The predicted optimal Hct/viscosity (h/η) ratio was higher in hypertensive women whose newborns exhibited a low birth weight (p = 0.03), resulting in a higher discrepancy between actual and model-predicted «ideal» values of h/η ratio (p = 0.03) and Hct (p = 0.02) compared with the subgroup with no growth retardation. Therefore, in hypertensive women whose newborns exhibited a low birth weight, hemorheological parameters predicting oxygen supply are shifted to lower values than predicted by the model.

Keywords: Blood fluidity, hemostasis, pregnancy, hypertensive disorders of pregnancy, obesity, preeclampsia, small for gestational age

DOI: 10.3233/CH-199002

Journal: Clinical Hemorheology and Microcirculation, vol. 71, no. 4, pp. 387-396, 2019