Objective: To investigate the variation of reference ranges of hemodynamic parameters in normal pregnancy and their relation to maternal basic characteristics. Methods: A total of 598 healthy pregnant women who underwent regular prenatal examination at the Third Affiliated Hospital of Guangzhou Medical University from January to December 2023 were prospectively enrolled, and noninvasive hemodynamic monitors were used to detect changes in hemodynamic parameters of the pregnant women with the week of gestation, including cardiac output (CO), stroke volume (SV), thoracic fluid content (TFC), systemic vascular resistance (SVR), mean arterial pressure (MAP), and heart rate (HR). Relationships between hemodynamic parameters and maternal basic characteristics, including age, height, and weight, were analyzed using restricted cubic spline. Results: (1) CO (r=0.155, P<0.001), TFC (r=0.338, P<0.001), MAP (r=0.204, P<0.001), and HR (r=0.352, P<0.001) were positively correlated with the week of gestation, and SV was negatively correlated with the week of gestation (r=-0.158, P<0.001). There was no significant correlation between SVR and gestational age (r=-0.051, P=0.258). (2) CO exhibited a positive correlation with maternal height and weight (all P<0.001). The taller and heavier of pregnant women, the higher their CO. A linear relationship was observed between maternal weight and SV, MAP and HR (all P<0.01). As maternal weight increased, SV, MAP and HR showed an upward trend. Furthermore, there was an inverse association between maternal age and SVR (P<0.001). (3) There was a significant nonlinear association observed between TFC and body mass index during pregnancy (P<0.05). Additionally, a nonlinear relationship was found between SVR and MAP in relation to maternal age (all P<0.05). Notably, when the age exceeded 31 years old, there was an evident upward trend observed in both SVR and MAP. Conclusions: The hemodynamic parameters of normal pregnant women are influenced by their height, body weight, and age. It is advisable to maintain a reasonable weight during pregnancy and give birth at an appropriate age.
目的： 探讨正常妊娠孕妇血流动力学参数正常参考范围的变化及其与孕妇基本特征的关系。 方法： 前瞻性纳入2023年1至12月在广州医科大学附属第三医院规律产前检查的健康孕妇共598例，采用无创血流动力学监测仪检测孕妇的血流动力学参数随孕周的变化情况，包括心输出量、每搏输出量、胸液水平、外周血管阻力、平均动脉压、心率。使用限制性立方样条模型分析血流动力学参数与孕妇基本特征，包括年龄、身高、体重之间的关系。 结果： （1）心输出量（r=0.155，P<0.001）、胸液水平（r=0.338，P<0.001）、平均动脉压（r=0.204，P<0.001）、心率（r=0.352，P<0.001）与孕周呈正相关；每搏输出量与孕周呈负相关（r=-0.158，P<0.001）；外周血管阻力与孕周无显著相关性（r=0.051，P=0.258）。（2）心输出量与孕妇的身高、体重均呈正相关（趋势检验P均<0.001），孕妇越高、越重，心输出量越高；每搏输出量、平均动脉压、心率与孕妇的体重均呈线性关系，外周血管阻力与孕妇的身高呈线性关系（趋势检验P均<0.01）；孕妇越重，每搏输出量、平均动脉压及心率越高；而孕妇越高，外周血管阻力越低。（3）胸液水平与孕期体重指数呈非线性关系（非线性检验P<0.05）；外周血管阻力、平均动脉压与孕妇年龄均呈非线性关系（非线性检验P均<0.05），年龄>31岁，外周血管阻力、平均动脉压呈上升趋势。 结论： 正常妊娠孕妇的血流动力学参数受其身高、体重、年龄的影响，倡导妊娠期合理控制体重、适龄婚育。.