Metabolic syndrome before 16 weeks’ gestation: prevalence and haemodynamic profile in a socioeconomically disadvantaged pregnancy cohort: baseline findings from Mother’s Heart Study

BACKGROUND: Pregnancy provides an opportunity to identify young women at risk of future cardiometabolic diseases. We aimed to determine the prevalence of metabolic syndrome (MetS) and its components, and to assess haemodynamic profiles in early pregnancy. METHOD: We recruited pregnant women at Lyell McEwin Hospital before 16 weeks' gestation. Haemodynamic parameters were measured using USCOM BP+ device. Blood glucose, lipid profile, liver and renal function were assessed. We included data from 264 women aged 19-44 years in the analyses. MetS was defined using the Harmonizing the MetS criteria. RESULTS: The prevalence of MetS was 15.1% (n = 40). Individual MetS components included high waist circumference (97.3%, n = 257), high systolic blood pressure (4.5%, n = 12), high diastolic blood pressure (1.1%, n = 3), high triglycerides (47.7%, n = 126), low high-density lipoprotein cholesterol (15.2%, n = 40), and elevated fasting blood glucose (1.4%, n = 1). Compared with women without MetS, women with MetS had higher peripheral systolic blood pressure, central systolic blood pressure (cSBP), central diastolic blood pressure, central mean arterial pressure (cMAP), pulse rate (PR), and suprasystolic pulse rate, and lower suprasystolic pulse rate variability, pressure gradient, reflected wave transit time to the reflected wave peak, and pulse pressure. After adjustment for BMI and correction for multiple testing, cSBP, cMAP and PR remained independently associated with MetS (all p < 0.05). CONCLUSIONS: MetS in early pregnancy is associated with changes in cardiovascular haemodynamics, with adiposity contributing to these changes. Early screening for MetS during pregnancy may provide an opportunity to identify women at increased risk of future cardiometabolic disease.