A possible new approach in the prediction of late gestational hypertension: The role of the fetal aortic intima-media thickness
The aim was to determine the predictive role of combined screening for late-onset gestational hypertension by fetal ultrasound measurements, third trimester uterine arteries (UtAs) Doppler imaging, and maternal history. This prospective study on singleton pregnancies was conducted at the tertiary ce...
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| Veröffentlicht in: | Medicine (Baltimore) 2017-01, Vol.96 (2), p.e5515-e5515 |
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| creator | Visentin, Silvia Londero, Ambrogio P Camerin, Martina Grisan, Enrico Cosmi, Erich |
| description | The aim was to determine the predictive role of combined screening for late-onset gestational hypertension by fetal ultrasound measurements, third trimester uterine arteries (UtAs) Doppler imaging, and maternal history. This prospective study on singleton pregnancies was conducted at the tertiary center of Maternal and Fetal Medicine of the University of Padua during the period between January 2012 and December 2014. Ultrasound examination (fetal biometry, fetal wellbeing, maternal Doppler study, fetal abdominal aorta intima-media thickness [aIMT], and fetal kidney volumes), clinical data (mother age, prepregnancy body mass index [BMI], and parity), and pregnancy outcomes were collected. The P value |
| doi_str_mv | 10.1097/MD.0000000000005515 |
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This prospective study on singleton pregnancies was conducted at the tertiary center of Maternal and Fetal Medicine of the University of Padua during the period between January 2012 and December 2014. Ultrasound examination (fetal biometry, fetal wellbeing, maternal Doppler study, fetal abdominal aorta intima-media thickness [aIMT], and fetal kidney volumes), clinical data (mother age, prepregnancy body mass index [BMI], and parity), and pregnancy outcomes were collected. The P value <0.05 was defined significant considering a 2-sided alternative hypothesis. The distribution normality of variables were assessed using Kolmogorov-Smirnoff test. Data were presented by mean (±standard deviation), median and interquartile range, or percentage and absolute values. We considered data from 1381 ultrasound examinations at 29 to 32 weeks' gestation, and in 73 cases late gestational hypertension developed after 34 weeks' gestation. The final multivariate model found that fetal aIMT as well as fetal umbilical artery pulsatility index (PI), maternal age, maternal prepregnacy BMI, parity, and mean PI of maternal UtAs, assessed at ultrasound examination of 29 to 32 weeks' gestation, were significant and independent predictors for the development of gestational hypertension after 34 weeks' gestation. The area under the curve of the model was 81.07% (95% confidence interval, 75.83%-86.32%). A nomogram was developed starting from multivariate logistic regression coefficients. Late-gestational hypertension could be independently predicted by fetal aIMT assessment at 29 to 32 weeks' gestation, ultrasound Doppler waveforms, and maternal clinical parameters.</description><identifier>ISSN: 0025-7974</identifier><identifier>EISSN: 1536-5964</identifier><identifier>DOI: 10.1097/MD.0000000000005515</identifier><identifier>PMID: 28079791</identifier><language>eng</language><publisher>United States: Wolters Kluwer Health</publisher><subject>Adult ; Aorta - diagnostic imaging ; Case-Control Studies ; Female ; Humans ; Hypertension, Pregnancy-Induced - diagnostic imaging ; Nomograms ; Observational Study ; Pregnancy ; Tunica Intima - diagnostic imaging ; Ultrasonography, Prenatal - methods</subject><ispartof>Medicine (Baltimore), 2017-01, Vol.96 (2), p.e5515-e5515</ispartof><rights>Copyright © 2017 the Author(s). Published by Wolters Kluwer Health, Inc. 2017</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c310t-91750958602ff7d49ad254f0d81cb9473d61afc38ed303e70c136fe8749e5a823</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC5266153/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC5266153/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,723,776,780,860,881,27901,27902,53766,53768</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/28079791$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Visentin, Silvia</creatorcontrib><creatorcontrib>Londero, Ambrogio P</creatorcontrib><creatorcontrib>Camerin, Martina</creatorcontrib><creatorcontrib>Grisan, Enrico</creatorcontrib><creatorcontrib>Cosmi, Erich</creatorcontrib><title>A possible new approach in the prediction of late gestational hypertension: The role of the fetal aortic intima-media thickness</title><title>Medicine (Baltimore)</title><addtitle>Medicine (Baltimore)</addtitle><description>The aim was to determine the predictive role of combined screening for late-onset gestational hypertension by fetal ultrasound measurements, third trimester uterine arteries (UtAs) Doppler imaging, and maternal history. This prospective study on singleton pregnancies was conducted at the tertiary center of Maternal and Fetal Medicine of the University of Padua during the period between January 2012 and December 2014. Ultrasound examination (fetal biometry, fetal wellbeing, maternal Doppler study, fetal abdominal aorta intima-media thickness [aIMT], and fetal kidney volumes), clinical data (mother age, prepregnancy body mass index [BMI], and parity), and pregnancy outcomes were collected. The P value <0.05 was defined significant considering a 2-sided alternative hypothesis. The distribution normality of variables were assessed using Kolmogorov-Smirnoff test. Data were presented by mean (±standard deviation), median and interquartile range, or percentage and absolute values. We considered data from 1381 ultrasound examinations at 29 to 32 weeks' gestation, and in 73 cases late gestational hypertension developed after 34 weeks' gestation. The final multivariate model found that fetal aIMT as well as fetal umbilical artery pulsatility index (PI), maternal age, maternal prepregnacy BMI, parity, and mean PI of maternal UtAs, assessed at ultrasound examination of 29 to 32 weeks' gestation, were significant and independent predictors for the development of gestational hypertension after 34 weeks' gestation. The area under the curve of the model was 81.07% (95% confidence interval, 75.83%-86.32%). A nomogram was developed starting from multivariate logistic regression coefficients. Late-gestational hypertension could be independently predicted by fetal aIMT assessment at 29 to 32 weeks' gestation, ultrasound Doppler waveforms, and maternal clinical parameters.</description><subject>Adult</subject><subject>Aorta - diagnostic imaging</subject><subject>Case-Control Studies</subject><subject>Female</subject><subject>Humans</subject><subject>Hypertension, Pregnancy-Induced - diagnostic imaging</subject><subject>Nomograms</subject><subject>Observational Study</subject><subject>Pregnancy</subject><subject>Tunica Intima - diagnostic imaging</subject><subject>Ultrasonography, Prenatal - methods</subject><issn>0025-7974</issn><issn>1536-5964</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2017</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpdUU1PJCEUJGaNzqq_wMRw3EsrNE3TeDAx6u6aaLzomTD0w2G3p2mB2Y0n_7pv4kdULoT3qopKFSH7nB1yptXR9fkh-3Ck5HKDzLgUbSV123wjM8ZqWSmtmm3yPec_jHGh6maLbNcdw7HmM_J0SqeYc5gPQEf4T-00pWjdgoaRlgXQKUEfXAlxpNHTwRag95CLXU_sQBePE6QCY8bnMb1FQoqohNA12UNBjI2pBIeCJSxttUQ9i9vg_o6Q8y7Z9HbIsPd675C7nxe3Z7-rq5tfl2enV5UTnJVKcyWZll3Lau9V32jb17LxrO-4m-tGib7l1jvRQS-YAMUcF62HTjUapO1qsUNOXnSn1RwtOBhLsoOZEnpKjybaYD5vxrAw9_GfkXXbYqYo8ONVIMWHFUZgliE7GAY7QlxlwzvZcYboNVS8QF3CaBP49284M-vqzPW5-Vodsg4-OnznvHUlngHzRJaZ</recordid><startdate>20170101</startdate><enddate>20170101</enddate><creator>Visentin, Silvia</creator><creator>Londero, Ambrogio P</creator><creator>Camerin, Martina</creator><creator>Grisan, Enrico</creator><creator>Cosmi, Erich</creator><general>Wolters Kluwer Health</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>20170101</creationdate><title>A possible new approach in the prediction of late gestational hypertension: The role of the fetal aortic intima-media thickness</title><author>Visentin, Silvia ; Londero, Ambrogio P ; Camerin, Martina ; Grisan, Enrico ; Cosmi, Erich</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c310t-91750958602ff7d49ad254f0d81cb9473d61afc38ed303e70c136fe8749e5a823</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2017</creationdate><topic>Adult</topic><topic>Aorta - diagnostic imaging</topic><topic>Case-Control Studies</topic><topic>Female</topic><topic>Humans</topic><topic>Hypertension, Pregnancy-Induced - diagnostic imaging</topic><topic>Nomograms</topic><topic>Observational Study</topic><topic>Pregnancy</topic><topic>Tunica Intima - diagnostic imaging</topic><topic>Ultrasonography, Prenatal - methods</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Visentin, Silvia</creatorcontrib><creatorcontrib>Londero, Ambrogio P</creatorcontrib><creatorcontrib>Camerin, Martina</creatorcontrib><creatorcontrib>Grisan, Enrico</creatorcontrib><creatorcontrib>Cosmi, Erich</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Medicine (Baltimore)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Visentin, Silvia</au><au>Londero, Ambrogio P</au><au>Camerin, Martina</au><au>Grisan, Enrico</au><au>Cosmi, Erich</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>A possible new approach in the prediction of late gestational hypertension: The role of the fetal aortic intima-media thickness</atitle><jtitle>Medicine (Baltimore)</jtitle><addtitle>Medicine (Baltimore)</addtitle><date>2017-01-01</date><risdate>2017</risdate><volume>96</volume><issue>2</issue><spage>e5515</spage><epage>e5515</epage><pages>e5515-e5515</pages><issn>0025-7974</issn><eissn>1536-5964</eissn><abstract>The aim was to determine the predictive role of combined screening for late-onset gestational hypertension by fetal ultrasound measurements, third trimester uterine arteries (UtAs) Doppler imaging, and maternal history. This prospective study on singleton pregnancies was conducted at the tertiary center of Maternal and Fetal Medicine of the University of Padua during the period between January 2012 and December 2014. Ultrasound examination (fetal biometry, fetal wellbeing, maternal Doppler study, fetal abdominal aorta intima-media thickness [aIMT], and fetal kidney volumes), clinical data (mother age, prepregnancy body mass index [BMI], and parity), and pregnancy outcomes were collected. The P value <0.05 was defined significant considering a 2-sided alternative hypothesis. The distribution normality of variables were assessed using Kolmogorov-Smirnoff test. Data were presented by mean (±standard deviation), median and interquartile range, or percentage and absolute values. We considered data from 1381 ultrasound examinations at 29 to 32 weeks' gestation, and in 73 cases late gestational hypertension developed after 34 weeks' gestation. The final multivariate model found that fetal aIMT as well as fetal umbilical artery pulsatility index (PI), maternal age, maternal prepregnacy BMI, parity, and mean PI of maternal UtAs, assessed at ultrasound examination of 29 to 32 weeks' gestation, were significant and independent predictors for the development of gestational hypertension after 34 weeks' gestation. The area under the curve of the model was 81.07% (95% confidence interval, 75.83%-86.32%). A nomogram was developed starting from multivariate logistic regression coefficients. Late-gestational hypertension could be independently predicted by fetal aIMT assessment at 29 to 32 weeks' gestation, ultrasound Doppler waveforms, and maternal clinical parameters.</abstract><cop>United States</cop><pub>Wolters Kluwer Health</pub><pmid>28079791</pmid><doi>10.1097/MD.0000000000005515</doi><oa>free_for_read</oa></addata></record> |
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| source | Wolters Kluwer Open Health; MEDLINE; DOAJ Directory of Open Access Journals; IngentaConnect Free/Open Access Journals; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; PubMed Central; Alma/SFX Local Collection |
| subjects | Adult Aorta - diagnostic imaging Case-Control Studies Female Humans Hypertension, Pregnancy-Induced - diagnostic imaging Nomograms Observational Study Pregnancy Tunica Intima - diagnostic imaging Ultrasonography, Prenatal - methods |
| title | A possible new approach in the prediction of late gestational hypertension: The role of the fetal aortic intima-media thickness |
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