Maternal arterial stiffness in hypertensive pregnancies with
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Pregnancies complicated by preclampsia with a small-for-gestational-age (SGA) neonate have poorer maternal hemodynamic function compared to those with hypertensive disorders of pregnancy (HDP) and an appropriately grown neonate. Arterial stiffness is a recognized prognostic marker of cardiovascular disease in the general population. The aim of this study was to compare maternal arterial stiffness between hypertensive pregnancies with, and those without, a SGA neonate and normotensive control pregnancies.

Included in the analysis were 69 patients with HDP who delivered a SGA neonate, 129 with HDP who delivered a normally grown neonate, and 220 healthy controls. Maternal age, weight, height and heart rate were associated significantly with brachial and aortic AIx. Adjusted aortic AIx was significantly higher in both the HDP+SGA and HDP only groups, compared with in controls, and was significantly different between the two HDP groups. Adjusted PWV was significantly higher in the HDP only group compared with in controls and the HDP+SGA group. Conversely, unadjusted PWV was not significantly different between the two HDP groups.

Pregnancies complicated by HDP with, and those without, a SGA neonate have significantly higher aortic AIx compared with uncomplicated normotensive pregnancies. Aortic AIx was highest in those pregnancies complicated by HDP with a SGA neonate, reflecting a progression in severity of arterial stiffness abnormality with a worsening clinical picture. These findings most likely reflect systemic reduced vascular compliance and increased systemic vascular resistance in pregnancy complicated by HDP

Source: https://obgyn.onlinelibrary.wiley.com/doi/full/10.1002/uog.21893
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