Description of Open- and Closed-Loop Cardiovascular and Cardiorespiratory Interactions at 11 – 14 weeks' gestation in Pregnancies that Subsequently Developed Preeclampsia

Preeclampsia (PE) affects 3-8% of all pregnancies and causes severe outcomes for the mother and offspring during and years after pregnancy. Clinical manifestation of PE starts in the 2nd - 3rd trimester, but some pregnant may be asymptomatic. Thus, to have proper management of PE and reduce severe maternal/fetal complications, early detection and prediction of PE is necessary, and remains challenging due to unknown PE origin and its heterogeneity. This study aims to explore mechanisms involving heart rate, systolic and diastolic blood pressure, and respiration in the first trimester of pregnancy, before clinical manifestation of PE. We studied a group of 23 Mexican first-trimester pregnant women who subsequently developed PE, a control group of 23 normotensive women throughout pregnancy, and a control group of normotensive pregnant without comorbidities. Preliminary results from this study showed increased hemodynamic indices in women that subsequently developed PE and no differences between studied groups in the baroreflex sensitivity open-loop assessment; meanwhile, some closed-loop interactions were different among the normotensive groups, which could be comorbidities-related. Moreover, we observed differences in the correlation of interaction indices with hemodynamic ones among the studied groups, having PE correlation with mean arterial pressure rather than pulse wave velocity. Clinical Relevance– This study shows differences in the closed-loop cardiovascular and cardiorespiratory interaction indices previous to the clinical manifestation of preeclampsia.