Association of Preeclampsia with P-wave and R-wave Peak Times of Electrocardiogram

Abstract

Background: Preeclampsia is a major contributor to maternal and neonatal morbidity and is increasingly linked to long-term cardiovascular risks. This study investigated the association between preeclampsia severity and electrocardiographic markers of atrial and ventricular conduction, specifically P-wave dispersion (Pd), P-wave peak time (PWPT), R-wave peak time (RWPT), and QT dispersion (QTd).

Methods: In this prospective observational study, 90 pregnant women receiving care at Kowsar Obstetrics and Gynecology Hospital, Urmia, Iran, were evaluated, comprising 60 preeclamptic cases (stratified by clinical criteria into mild, n=30, and severe, n=30) and 30 age- and gestational age-matched normotensive pregnant controls. Preoperative 12-lead electrocardiograms (ECGs) were obtained prior to scheduled cesarean section. Continuous ECG parameters were compared across groups using ANOVA and Tukey’s post-hoc tests, with statistical significance defined as p< 0.05.

Results: Significant electrophysiological variations were observed across groups. The mean P-wave peak time in lead II progressively prolonged with preeclampsia severity, measuring 41.15±4.65 ms in severe preeclampsia, 36.17±8.13 ms in mild preeclampsia, and 30.10±7.85 ms in controls (p=0.001). Similarly, significant progressive prolongations were noted for PWPT in lead V1, as well as RWPT in leads V5 (38.70±7.27 ms vs. 32.38±5.65 ms vs. 28.34±6.89 ms; p=0.001) and V6 (36.72± 7.62 ms vs. 32.04±5.62 ms vs. 25.90±6.65 ms; p=0.001).

Conclusion: Preeclampsia is associated with distinct alterations in atrial depolarization and ventricular repolarization, as evidenced by the prolongation of surface ECG parameters such as Pd, RWPT, and QTd. Early identification of these non-invasive ECG abnormalities in preeclamptic patients provides an opportunity for early risk stratification and timely cardiovascular monitoring.