Feasibility of neonatal pulse wave velocity and association with maternal hemoglobin A1c

Neonatology. 2015;107(1):20-6. doi: 10.1159/000366467. Epub 2014 Oct 4.

Abstract

Background: Use of non-invasive peripheral arterial tonometry to assess arterial stiffness has not been studied in neonates. Perinatal factors impact childhood vascular health, but the effect in neonates remains to be examined.

Objectives: To examine the feasibility of pulse wave velocity (PWV) among healthy term neonates, and to evaluate the effects of perinatal factors on neonatal PWV.

Methods: Pregnant women with singleton gestation presenting for routine care were enrolled. Postnatally, PWV measurements of their neonates were obtained using an arterial tonometer. A variability index was calculated for each PWV measurement. Intra- and inter-observer reproducibility were illustrated with Bland-Altman plots. Medical records were reviewed. Relationships between neonatal PWV and perinatal factors were examined.

Results: PWV measurements were attempted in 76 neonates and successfully obtained in 67 (88%). Using PWV measurements with a variability index ≤ 0.25 (48 neonates), the intra-class coefficient was 0.69. The mean differences (limits of agreement) for intra- and inter-rater reproducibility were 0.02 (-3.64 to 3.60) and 0.34 (-2.23 to 2.39), respectively. Median neonatal PWV was 2.80 m/s (range 0.60-8.40). Neonates of mothers with HgbA1c ≥6% had significantly higher PWV than neonates of mothers with HgbA1c <6% (4.12 m/s, 95% CI 3.22-5.02, vs. 2.78 m/s, 95% CI 2.28-3.28, p = 0.02).

Conclusions: Neonatal PWV using peripheral arterial tonometry is feasible and reproducible when using measurements with a variability index ≤ 0.25. Neonates of mothers with increased HgbA1c had higher PWV, suggesting an effect of maternal hyperglycemia on neonatal vasculature. The long-term implications of this finding warrant further investigation.

MeSH terms

  • Adult
  • Arteries / physiopathology
  • Feasibility Studies
  • Female
  • Glycated Hemoglobin / analysis*
  • Humans
  • Hyperglycemia* / diagnosis
  • Hyperglycemia* / etiology
  • Hyperglycemia* / physiopathology
  • Hyperglycemia* / prevention & control
  • Infant Health
  • Infant, Newborn
  • Manometry / methods
  • Pregnancy
  • Pregnancy Complications* / diagnosis
  • Pregnancy Complications* / physiopathology
  • Pregnancy Complications* / prevention & control
  • Prenatal Exposure Delayed Effects
  • Pulse Wave Analysis / methods*
  • Statistics as Topic
  • Vascular Stiffness*

Substances

  • Glycated Hemoglobin A