3.7 ARTERIAL STIFFNESS FOR THE EARLY PREDICTION OF PRE-ECLAMPSIA COMPARED WITH CLINICAL CHARACTERISTICS, UTERINE ARTERY DOPPLER INDICES, AND ANGIOGENIC BIOMARKERS

DOI

10.1016/j.artres.2016.10.017How to use a DOI?

Abstract

Objective: To develop a model for the 1^st trimester prediction of pre-eclampsia.

Methods: In this prospective longitudinal study, women with high-risk singleton pregnancies were recruited and arterial stiffness was measured using applanation tonometry (SphygmoCor, AtCor) and compared between women who developed PE and those who had a normotensive pregnancy. Arterial stiffness and hemodynamics were assessed, in the 1^st trimester, every 4 weeks thereafter, and at 6 weeks postpartum. Angiogenic biomarker concentrations (Quantikine, R&D Systems) were measured at each trimester and at 6 weeks postpartum, and a bilateral uterine artery Doppler (UAD) was performed in the 2^nd trimester.

Results: Of the 155 women recruited, 13 developed pre-eclampsia. Analyses adjusted for both maternal age and body mass index showed women who developed pre-eclampsia had significantly increased wave reflection and carotid-femoral pulse wave velocity (cfPWV) from the 1^st trimester, throughout pregnancy, and at 6 weeks post-partum with a cfPWV:carotid-radial PWV mistmatch seen in the 1^st and 3^rd trimester (all p-values<0.05). Arterial stiffness (AUC: 0.80) was a better predictive tool than angiogenic biomarkers (AUC: 0.60; p=0.04) or UAD (AUC: 0.53; p<0.001) and improved detection of pre-eclampsia when combined with all other predictions (AS sensitivity: 79.8% vs other combinations’ sensitivity: 69.2%).

Conclusions: Arterial stiffness and wave reflection is higher in the 1^st trimester, throughout pregnancy, and does not resolve 6 weeks after pregnancy in women who develop pre-eclampsia. It also had superior preeclampsia predictive value over angiogenic biomarkers and UAD alone and improved detection rates when combined with all predictors including clinical characteristics.

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TY  - JOUR
AU  - Kim Phan
AU  - Yessica Haydee Gomez
AU  - Jessica Gorgui
AU  - Amira El-Messidi
AU  - Robert Gagnon
AU  - Stella Daskalopoulou
PY  - 2016
DA  - 2016/11/24
TI  - 3.7 ARTERIAL STIFFNESS FOR THE EARLY PREDICTION OF PRE-ECLAMPSIA COMPARED WITH CLINICAL CHARACTERISTICS, UTERINE ARTERY DOPPLER INDICES, AND ANGIOGENIC BIOMARKERS
JO  - Artery Research
SP  - 52
EP  - 52
VL  - 16
IS  - C
SN  - 1876-4401
UR  - https://doi.org/10.1016/j.artres.2016.10.017
DO  - 10.1016/j.artres.2016.10.017
ID  - Phan2016
ER  -