Effect of supine or semi-recumbent positions on arterial stiffness among pregnant women

Abstract

OBJECTIVE: We aimed to evaluate whether there was a difference in arterial stiffness measurements in supine and semirecumbent positions among pregnant women. METHODS: This was a cross-sectional study in four public hospitals in Uganda. Women were interviewed to capture demographic data and obstetric history before undergoing arterial stiffness examinations using the Arteriograph device (TensioMed, Budapest, Hungary) in supine and semirecumbent positions. Three consecutive measurements were acquired per position and were transformed to gestational age adjusted z-scores for analysis using a two-sample t-test, paired t-test and Pearson correlation coefficients. RESULTS: We included 194 pregnant women, with median age of 25 years (interquartile rage (IQR), 21-29), and body mass index of 23.9 kg/m2 (IQR, 21.1-27.6). None was smoking or had renal and cardiac diseases. The procedure failure rate was less than 3 %. There were no significant differences in measurements between supine and semirecumbent positions at 11-42 weeks. We found a strong positive correlation between hemodynamic indices performed in supine and semirecumbent positions: aortic pulse wave velocity z-scores (r = 0.84 (95 % CI, 0.77-0.89)) and aortic augmentation index z-scores (r = 0.95 (95 % CI, 0.92-0.97)) at 11-27 weeks' gestation, and central systolic blood pressure z-scores (r = 0.81 (95 % CI, 0.72-0.87)) and mean arterial pressure z-scores (r = 0.84 (95 % CI, 0.77-0.89)) at 28-42 weeks' gestation. Repeated measurements taken in same position were strongly correlated throughout gestation. CONCLUSION: Arterial stiffness parameters measured in supine and semirecumbent positions were comparable and had very minimal failure rates. As a supine position is often not tolerated well in late gestation, our study suggests that pregnant women could assume a semirecumbent position during Arteriograph test procedures between 11 and 42 weeks of gestation.