Department of Physiology, Government Allopathic Medical College, Banda, Uttar Pradesh, India.
Department of Physiology, All India Institute of Medical Sciences, New Delhi, India.
Pregnancy Hypertens. 2019 Oct;18:88-95. doi: 10.1016/j.preghy.2019.09.013. Epub 2019 Oct 1.
To evaluate the temporal profile of arterial functions during the course of pregnancy and also to determine the predictive accuracy of vascular function indices in development of preeclampsia (PE).
Longitudinal study, two hundred and eight women participated in the study and vascular functions were assessed at 11-13, 20-22 and 30-32 weeks of gestation.
Flow mediated dilatation (FMD), augmentation index (AIx), pulse wave velocity (PWV).
Out of 208 women, 13 women developed PE while 70 remained healthy pregnant (HP). In HP women, normalized FMD decreased gradually from 11 to 13 weeks to 30-32 weeks of gestation (p < 0.05). While in PE, Normalized FMD decreased from 11 to 13 to 20-22 weeks of gestation (p < 0.05) and was significantly lower in PE than HP group at 20-22 weeks of gestation (p < 0.05). AIx showed a mid trimester drop in HP group (p < 0.05) while demonstrated a rising trend in PE. Both AIx and PWV were significantly higher in PE than HP group during the course of pregnancy (p < 0.05). AIx demonstrated good sensitivity and specificity at both 11-13 and 20-22 weeks of gestation. Carotid femoral PWV showed an area under curve (AUC) of 78.18% and 69.75% at 11-13 and 20-22 weeks of gestation respectively. Carotid radial PWV showed good accuracy at 20-22 weeks (AUC-77.58%) of gestation.
Compromised arterial functions precede the onset of PE. AIx and carotid femoral PWV constitute potential predictive marker in early pregnancy for later development of PE.
评估妊娠过程中动脉功能的时程变化，并确定血管功能指标在子痫前期（PE）发展中的预测准确性。
纵向研究，208 名女性参与了研究，在 11-13、20-22 和 30-32 周妊娠时评估血管功能。
血流介导的扩张（FMD）、增强指数（AIx）、脉搏波速度（PWV）。
在 208 名女性中，有 13 名女性发展为 PE，而 70 名女性为健康孕妇（HP）。在 HP 女性中，正常化 FMD 从 11 周到 13 周到 30-32 周妊娠逐渐降低（p<0.05）。而在 PE 中，正常化 FMD 从 11 周到 13 周到 20-22 周妊娠降低（p<0.05），且在 20-22 周妊娠时明显低于 HP 组（p<0.05）。AIx 在 HP 组中表现为中期下降（p<0.05），而在 PE 中表现为上升趋势。在整个妊娠过程中，AIx 和 PWV 在 PE 组中均明显高于 HP 组（p<0.05）。AIx 在 11-13 和 20-22 周妊娠时均具有良好的敏感性和特异性。颈动脉-股动脉 PWV 在 11-13 和 20-22 周妊娠时的曲线下面积（AUC）分别为 78.18%和 69.75%。颈动脉-桡动脉 PWV 在 20-22 周妊娠时具有良好的准确性（AUC-77.58%）。
动脉功能受损先于 PE 的发生。AIx 和颈动脉-股动脉 PWV 构成了妊娠早期预测 PE 发生的潜在预测标志物。
