Second- and Third-Trimester Placental Hemodynamics and the Risks of Pregnancy Complications
Second- and Third-Trimester Placental Hemodynamics and the Risks of Pregnancy Complications
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DOI：
10.1093/aje/kws296
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发表时间：
2013-04-15
影响因子：
5
通讯作者：
Jaddoe, Vincent W. V.
中科院分区：
文献类型：
--
作者：
Gaillard, Romy;Arends, Lidia R.;Jaddoe, Vincent W. V.
子宫动脉和脐动脉血流模式的特征是子宫胎盘循环的间接测量。我们研究了子宫动脉和脐动脉阻力指数是否受产妇人口统计学和生活方式特征的影响，从孕中期到孕晚期，并与妊娠并发症的风险相关。这项分析纳入了“R世代研究”（荷兰鹿特丹，2001 - 2005年）中的7 660名孕妇。在第二和第三孕期评估胎盘阻力指数。妊娠结局的信息来自医疗记录。母亲的特点影响中期和晚期妊娠胎盘阻力指数。子宫动脉阻力指数和脐动脉搏动指数的相关系数分别为0.50和0.32。妊娠中期和妊娠晚期较高的胎盘阻力指数以及妊娠中期至妊娠晚期子宫动脉阻力指数持续处于最高三分位数与先兆子痫、早产和出生时小于胎龄儿的风险相关（所有Ps均<0.05）。我们的研究表明，胎盘阻力指数受母体人口统计学和生活方式特征的影响，并从孕中期到孕晚期适度跟踪。妊娠中期和妊娠晚期胎盘阻力指数增加与不良妊娠结局风险增加相关。
Characteristics of the uterine and umbilical artery blood flow patterns are indirect measures of uteroplacental circulation. We examined whether uterine and umbilical artery resistance indices are influenced by maternal demographic and lifestyle characteristics, track from the second trimester to the third, and are associated with the risk of pregnancy complications. This analysis was embedded among 7,660 pregnant women in the Generation R Study (Rotterdam, the Netherlands, 20012005). Placental resistance indices were assessed in the second and third trimesters. Information about pregnancy outcomes was obtained from medical records. Maternal characteristics affected second- and third-trimester placental resistance indices. Correlation coefficients for correlation between the second and third trimesters were 0.50 and 0.32 for uterine artery resistance index and umbilical artery pulsatility index, respectively. Higher placental resistance indices in the second and third trimesters and persistence in the highest tertile of uterine artery resistance index from the second trimester to the third were associated with the risks of preeclampsia, preterm birth, and small size for gestational age at birth (all Ps 0.05). Our study shows that placental resistance indices are influenced by maternal demographic and lifestyle characteristics and track moderately from the second trimester to the third. Increased placental resistance indices in the second and third trimesters are associated with increased risks of adverse pregnancy outcomes.