title: Maternal hemodynamics at 11-13 weeks of gestation in pregnancies delivering small for gestational age neonates.
abstract: OBJECTIVE
  To examine aortic systolic blood pressure (SBP(Ao)), 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, SBP(Ao), 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 SBP(Ao) (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), SBP(Ao) (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).
  
  
  CONCLUSIONS
  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 SBP(Ao) and AIx-75.
authors.affiliation: Department of Fetal Medicine, Institute for Women's Health, University College London Hospitals, London, UK.
authors.forename: A
authors.initials: A
authors.lastname: Khalil
authors.forename: D
authors.initials: D
authors.lastname: Sodre
authors.forename: A
authors.initials: A
authors.lastname: Syngelaki
authors.forename: R
authors.initials: R
authors.lastname: Akolekar
authors.forename: K H
authors.initials: KH
authors.lastname: Nicolaides
mesh_terms: D000328:Adult; D002318:Cardiovascular Diseases / Q000453:epidemiology / Q000209:etiology; D005260:Female; D005317:Fetal Growth Retardation / Q000097:blood / Q000453:epidemiology / Q000209:etiology* / Q000503:physiopathology; D006439:Hemodynamics; D006801:Humans; D007231:Infant, Newborn; D007236:Infant, Small for Gestational Age; D008297:Male; D010929:Placentation; D011225:Pre-Eclampsia / Q000000981:diagnostic imaging / Q000503:physiopathology*; D011247:Pregnancy; D011261:Pregnancy Trimester, First; D011266:Pregnancy-Associated Plasma Protein-A / Q000032:analysis; D011296:Prenatal Diagnosis; D011446:Prospective Studies; D012306:Risk; D014463:Ultrasonography; D006113:United Kingdom / Q000453:epidemiology; D055988:Uterine Artery / Q000000981:diagnostic imaging / Q000503:physiopathology*; D059289:Vascular Stiffness
chemical_list: D011266:Pregnancy-Associated Plasma Protein-A; C579283:PAPPA protein, human