The main goal of this study is to investigate the association of dietary salt intake during pregnancy with systemic micro- and macrovascular reactivity and uteroplacental vascular function of the mother, and to examine the potential impact of elevated oxidative stress on this association. Also, the aim is to investigate whether there is an association between excessive salt intake during pregnancy and the outcome of pregnancy.
During the study pregnant women at the third trimester of pregnancy (37-38 weeks of pregnancy) will have one study visit during which following procedures will be done: * measurement of maternal systemic microvascular function by Laser Doppler flowmetry (post-occlusive reactive hyperemia, iontophoresis of acetylcholine and sodium nitroprusside) * measurement of maternal systemic macrovascular function by vascular ultrasound measurement of brachial artery flow mediated dilation (FMD) * measurement of maternal uteroplacental function by ultrasound color Doppler measurement of umbilical artery and fetal middle cerebral artery blood flow * venous blood sampling; serum will be stored for measurement of oxidative stress, matrix metalloproteinase 9 and endocan level * 24-hour urine natriuresis (to estimate daily salt intake) * measurement of blood pressure, heart rate, height and weight, body composition Immediately after the childbirth following procedures will be done: * assessment of pregnancy outcome (duration of pregnancy, child birth weight, child birth length and Apgar score) * placental tissue will be taken and stored for measurement of matrix metalloproteinase 9
Study Type
OBSERVATIONAL
Enrollment
80
Osijek University Hospital
Osijek, Croatia
RECRUITINGMaternal systemic microvascular function
Skin microvascular reactivity assessed by Laser Doppler flowmetry (post-occlusive reactive hyperemia, iontophoresis of acetylcholine and sodium nitroprusside) - measured in perfusion units (PU)
Time frame: at one time point in the third trimester of pregnancy (37-38 weeks of pregnancy)
Maternal systemic macrovascular function
Vascular ultrasound measurement of brachial artery flow mediated dilation (FMD)
Time frame: at one time point in the third trimester of pregnancy (37-38 weeks of pregnancy)
Maternal uteroplacental function
Ultrasound color Doppler measurement of umbilical artery and fetal middle cerebral artery blood flow
Time frame: at one time point in the third trimester of pregnancy (37-38 weeks of pregnancy)
Oxidative stress - thiobarbituric acid reactive substances (TBARS)
Measurement of biomarkers of oxidative stress level. Thiobarbituric acid reactive substances (TBARS) - biomarker of lipid peroxidation.
Time frame: at one time point in the third trimester of pregnancy (37-38 weeks of pregnancy)
Matrix metalloproteinase 9
ELISA measurement of serum matrix metalloproteinase 9 level in mother serum and placental tissue sample (taken after childbirth)
Time frame: at one time point in the third trimester of pregnancy (37-38 weeks of pregnancy) (serum) and immediately after childbirth (placental tissue sample)
Endocan
ELISA measurement of serum endocan level - proteoglycan associated with endothelium activation
Time frame: at one time point in the third trimester of pregnancy (37-38 weeks of pregnancy)
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Pregnancy outcome - duration
Duration of pregnancy (weeks and days)
Time frame: the outcome measure will be assessed at one time point in the third trimester of pregnancy (37-38 weeks of pregnancy)
Pregnancy outcome - birth weight
Birth weight (in grams)
Time frame: at one time point immediately after childbirth
Pregnancy outcome - birth length
Birth length (in cm)
Time frame: at one time point immediately after childbirth
Pregnancy outcome - Apgar score
Apgar score (in Apgar score scale, a total score of 1 to 10; the higher the score, the better the baby is doing after birth)
Time frame: at one time point immediately after childbirth