Maternal physiologic adaptations to early human pregnancy

Abstract

This study was designed to test the hypothesis that significant maternal physiologic adaptations to pregnancy take place in multiple systems long before they are functionally necessary (during the embryonic period). To test this hypothesis, 20 women were studied serially before pregnancy and in the seventh and fifteenth postconceptional week of an accurately dated, clinically normal, singleton pregnancy. By the seventh week, significant changes were noted in body composition and cardiopulmonary and metabolic functions. Body fat and plasma volume increased 2% and 11%, respectively, accounting for all of the observed 2 kg weight gain. With the patient standing at rest after eating, heart rate increased 13 beats/min (16%) while mean arterial pressure fell 8 mm Hg (9%). Minute ventilation rose 24% and oxygen consumption increased by 27 ml/min, or 10%. The postprandial respiratory exchange ratio also increased, from 0.78 to 0.83; the whole blood glucose level was unchanged at rest, although there was a 15% decrease in whole blood lactate levels. We conclude that our hypothesis is correct, which suggests these adaptations are preparative and may have diagnostic value.