Study On The Correlation Between Weight Gain And Changes Of Left Ventricular Structure And Function During Pregnancy

【Objective】To investigate the adaptive changes of left ventricular structure and function in pregnant women,and the effects of weight gain during pregnancy on left ventricular structure and function,so as to find out the warning effect of excessive weight gain on potential cardiac insufficiency.【Methods】Data were collected from 116 healthy pregnant women in the early,middle and late stages of pregnancy for analysis.1.Data acquisition:(1)basic parameters: age,fetal size,height,early,middle and late gestational weight,and the rate of weight gain during the second trimester--early trimester,late trimester--middle trimester;(2)echocardiography of left heart structure and function parameters,left atrial volume index(LAV),left ventricular volume(LVV),left ventricular mass(LVM),left atrial volume index(LAVI),left ventricular volume index(LVVI),left ventricular mass index(LVMI),left ventricular ejection fraction(LVEF),mean peak velocity of mitral ring in early diastole(e ’);Peak mitral filling velocity in early diastolic period/peak mitral ring diastolic period(E/e ’);2.To observe the differences of age,the number of pregnancy,pre-pregnancy weight distribution of all subjects and the weight gain of pregnant women with different pre-pregnancy weight in the second and third trimester;3.All pregnant women were divided into groups according to the early,middle and late stages of pregnancy,and the differences in left ventricular structure and function among different groups were compared and analyzed;4.Analyze the correlation between age,fetal size,weight gain degree and left ventricular structure and functional indicators;5.In the early pregnancy,the pregnant women with normal weight and light weight were grouped into one group,and those with overweight and obesity were grouped into one group,and the differences in left ventricular structure and function between the two groups were compared and analyzed.6.In the second and third trimester of pregnancy,pregnant women were divided into groups with normal weight gain and those with excessive weight gain according to different weight gain conditions,and the differences in left ventricular structure and function between the two groups were compared and analyzed.【Results】1.Advanced age: 21.5%,non-advanced age: 78.5%,primipara: 46.6%,multipara:53.4%.The weight of pregnant women in the early pregnancy was 27.5%,normal:48.3%,overweight: 18.9%,and obesity: 5.3%.With the increase of gestational weeks,the probability of excessive weight gain in different groups was respectively.Underweight group: 9.4% in the second-trimester and 46.9% in the third trimester.Normal group: 50% in the second-trimester and 57.1% in the third trimester.Overweight group: 77.3% in the second-trimester,90.9% in the third trimester;Obesity group: 83.3% in the second-trimester and 100% in the third trimester.2.As the growth of the gestational age,LAV,LVV,LAVI,LVVI,LVM,LVMI,E/e’increased gradually,LVEF,e’ gradually decreases,and the changes in late pregnancy to maximum,mid pregnancy when compared with the early stages of pregnancy only LAV,LVV,LVEF,LVM,LVMI have significant difference(P < 0.05),late pregnancy compared with mid pregnancy when all indicators have significant difference(P < 0.05).3.(1)LVM and LVMI,LVV,LVVI was positively correlated with degree of weight gain(r = 0.575,r = 0.218,r = 0.234,r = 0.239,r = 0.357,r = 0.239,P <0.05);(2)the LVM,LVMI,LVVI was positively related with tire time(r = 0.403,r =0.268,r = 0.192,r = 0.192,P < 0.05);(3)the LVEF is negatively correlated with fetal time(r = 0.211,P < 0.05),and negatively correlated with the degree of weight gain(r= 0.284,P < 0.05).4.In early pregnancy,compared with the normal and light weight groups,the LAV,LVV,LAVI,LVVI,LVM,LVMI and E/e’ increased,the LVEF and e’ decreased in the overweight and obese groups,but only LAV,LVV,LAVI,LVM and LVEF showed significant differences(P < 0.05).5.In the second-trimester,LVV,LVVI,LVM,LAV,LAVI,LVMI and E/e’ all increased and LVEF and e’ all decreased in the overweight group compared with the normal group,but only LVV,LVVI,LVM and LVEF showed significant differences(P < 0.05).In the third trimester,LAV,LVV,LAVI,LVVI,LVM,LVMI and E/e’ all increased and LVEF and e’ all decreased in the overweight group,compared with the normal group,except for e’,with significant differences(P < 0.05).【Conclusion】The left ventricular structure and function of pregnant women have adaptive physiological changes with the growth of gestational weeks.Excessive weight gain during pregnancy can lead to left ventricular hypertrophy and left ventricular systolic and diastolic dysfunction.By monitoring pregnant women’s weight gain during pregnancy,cardiac dysfunction during pregnancy can be predicted and timely intervention can reduce the cardiovascular risk of pregnancy.