Maternal Hemodynamics at 11-13 Weeks of Gestation in Pregnancies Delivering Small for Gestational Age Neonates

被引:19
|
作者
Khalil, A. [2 ]
Sodre, D. [2 ]
Syngelaki, A.
Akolekar, R. [3 ]
Nicolaides, K. H. [1 ,2 ]
机构
[1] Kings Coll Hosp London, Harris Birthright Res Ctr Fetal Med, Dept Fetal Med, London SE5 9RS, England
[2] Univ Coll London Hosp, Inst Womens Hlth, Dept Fetal Med, London, England
[3] Medway Maritime Hosp, Dept Fetal Med, Gillingham, Kent, England
关键词
Pyramid of prenatal care; Preeclampsia; Arterial stiffness; Small for gestational age; Fetal growth restriction; Pulse wave velocity; PULSE-WAVE ANALYSIS; PREDICTS CARDIOVASCULAR MORTALITY; UTERINE ARTERY DOPPLER; BIRTH-WEIGHT; HYPERTENSIVE DISORDERS; VASCULAR-DISEASE; HEART-DISEASE; PREECLAMPSIA; RISK; STIFFNESS;
D O I
10.1159/000339480
中图分类号
R71 [妇产科学];
学科分类号
100211 ;
摘要
Objective: To examine aortic systolic blood pressure (SBPAo), pulse wave velocity (PWV) and augmentation index (adjusted to a heart rate of 75 beats per minute, AIx-75) at 11-13 weeks' gestation in pregnancies delivering small for gestational age (SGA) neonates with and without preeclampsia (PE). Methods: At 11+0 to 13+6 weeks' gestation, maternal history was recorded and PWV, AIx-75, SBPAo, uterine artery pulsatility index (PI) and maternal serum pregnancy-associated plasma protein-A (PAPP-A) were measured. We compared women with (n = 337) and without (n = 48) PE that delivered SGA neonates with unaffected controls (n = 6,429). Results: In the SGA group without PE, compared to unaffected controls, there was no significant difference in AIx-75 (1.03 vs. 1.00 multiple of the median, MoM), PWV (0.98 vs. 1.00 MoM) or SBPAo (1.01 vs. 1.00 MoM), but uterine artery PI was increased (1.10 vs. 1.00 MoM) and PAPP-A decreased (0.85 vs. 1.00 MoM). In SGA with PE, compared to unaffected controls, there was increased AIx-75 (1.13 vs. 1.00 MoM), SBPAo (1.09 vs. 1.00 MoM), uterine artery PI (1.40 vs. 1.00 MoM) and decreased PAPP-A (0.72 vs. 1.00 MoM), but no significant difference in PWV (1.05 vs. 1.00 MoM). Conclusion: In pregnancies with SGA neonates, impaired placentation is reflected in low PAPP-A and high uterine artery PI at 11-13 weeks' gestation. In the SGA group with PE, but not in those without PE, there is increased SBPAo and AIx-75. Copyright (c) 2012 S. Karger AG, Basel
引用
收藏
页码:231 / 238
页数:8
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