{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,21]],"date-time":"2026-01-21T03:53:49Z","timestamp":1768967629234,"version":"3.49.0"},"reference-count":38,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2019,3,14]],"date-time":"2019-03-14T00:00:00Z","timestamp":1552521600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100000272","name":"National Institute for Health Research","doi-asserted-by":"publisher","award":["NIHR\u2010CS\u2010011\u2010020"],"award-info":[{"award-number":["NIHR\u2010CS\u2010011\u2010020"]}],"id":[{"id":"10.13039\/501100000272","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Ultrasound in Obstet &amp;amp; Gyne"],"published-print":{"date-parts":[[2019,5]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Objectives<\/jats:title><jats:p>Raised vascular function measures are associated with adverse maternal and perinatal outcomes in low\u2010risk pregnancy. This study aimed to evaluate the association between longitudinal vascular function parameters and adverse outcome in pregnant women with chronic hypertension, and to assess whether these measures vary according to baseline parameters such as black ethnicity.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This was a nested cohort study of women with chronic hypertension and a singleton pregnancy recruited to the PANDA (Pregnancy And chronic hypertension: NifeDipine <jats:italic>vs<\/jats:italic> lAbetalol as antihypertensive treatment) study at one of three UK maternity units. Women had serial pulse\u2010wave analyses performed using the Arteriograph\u00ae, while in a sitting position, from 12\u2009weeks' gestation onwards. Statistical analysis was performed using random\u2010effects logistic regression models. Longitudinal vascular parameters were compared between women who developed superimposed pre\u2010eclampsia (SPE) and those who did not, between women who delivered a small\u2010for\u2010gestational\u2010age (SGA) infant (birth weight &lt;\u200910<jats:sup>th<\/jats:sup> centile) and those who delivered an infant with birth weight \u2265\u200910<jats:sup>th<\/jats:sup> centile and between women of black ethnicity and those of non\u2010black ethnicity.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The cohort included 97 women with chronic hypertension and a singleton pregnancy, of whom 90% (<jats:italic>n<\/jats:italic>\u00a0=\u200987) were randomized to antihypertensive treatment and 57% (<jats:italic>n<\/jats:italic>\u00a0=\u200955) were of black ethnicity, with up to six (mean, three) longitudinal vascular function assessments. SPE was diagnosed in 18% (<jats:italic>n<\/jats:italic>\u00a0=\u200917) of women and 30% (n\u2009=\u200929) of infants were SGA. In women who developed subsequent SPE, compared with those who did not, mean brachial systolic blood pressure (SBP) (148\u2009mmHg <jats:italic>vs<\/jats:italic> 139\u2009mmHg; <jats:italic>P<\/jats:italic>\u00a0=\u20090.002), mean diastolic blood pressure (DBP) (87\u2009mmHg <jats:italic>vs<\/jats:italic> 82\u2009mmHg; <jats:italic>P<\/jats:italic>\u00a0=\u20090.01), mean central aortic pressure (139\u2009mmHg <jats:italic>vs<\/jats:italic> 128\u2009mmHg; <jats:italic>P<\/jats:italic>\u00a0=\u20090.001) and mean augmentation index (AIx\u201075) (29% <jats:italic>vs<\/jats:italic> 22%; <jats:italic>P<\/jats:italic>\u00a0=\u20090.01) were significantly higher across gestation. In women who delivered a SGA infant compared to those who delivered an infant with birth weight \u2265\u200910<jats:sup>th<\/jats:sup> centile, mean brachial SBP (146\u2009mmHg <jats:italic>vs<\/jats:italic> 138\u2009mmHg; <jats:italic>P<\/jats:italic>\u00a0=\u20090.001), mean DBP (86\u2009mmHg <jats:italic>vs<\/jats:italic> 82\u2009mmHg; <jats:italic>P<\/jats:italic>\u00a0=\u20090.01), mean central aortic pressure (137\u2009mmHg <jats:italic>vs<\/jats:italic> 127\u2009mmHg; <jats:italic>P<\/jats:italic>\u2009&lt;\u20090.0001) and mean pulse\u2010wave velocity (9.1\u2009m\/s <jats:italic>vs<\/jats:italic> 8.5\u2009m\/s; <jats:italic>P<\/jats:italic>\u00a0=\u20090.02) were higher across gestation. No longitudinal differences were found in vascular function parameters in women of black ethnicity compared with those of non\u2010black ethnicity.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>There were persistent differences in vascular function parameters and brachial blood pressure throughout pregnancy in women with chronic hypertension who later developed adverse maternal or perinatal outcome. Further investigation into the possible clinical use of these findings is warranted. Copyright \u00a9 2018 ISUOG. Published by John Wiley &amp; Sons Ltd.<\/jats:p><\/jats:sec>","DOI":"10.1002\/uog.19021","type":"journal-article","created":{"date-parts":[[2018,1,30]],"date-time":"2018-01-30T15:13:12Z","timestamp":1517325192000},"page":"638-648","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Longitudinal changes in vascular function parameters in pregnant women with chronic hypertension and association with adverse outcome: a cohort study"],"prefix":"10.1002","volume":"53","author":[{"given":"L. M.","family":"Webster","sequence":"first","affiliation":[{"name":"Women's Health Academic Centre, King's College London St Thomas' Hospital  London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"J. E.","family":"Myers","sequence":"additional","affiliation":[{"name":"Maternal &amp; Fetal Health Research Centre, University of Manchester, Manchester Academic Health Science Centre Central Manchester Foundation Trust  Manchester UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"C.","family":"Nelson\u2010Piercy","sequence":"additional","affiliation":[{"name":"Women's Health Academic Centre, King's College London St Thomas' Hospital  London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"C.","family":"Mills","sequence":"additional","affiliation":[{"name":"King's College London Division of Life Course Sciences, Department of Nutritional Sciences  London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"I.","family":"Watt\u2010Coote","sequence":"additional","affiliation":[{"name":"Fetal Medicine Unit, St George's University Hospitals NHS Foundation Trust University of London  London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"A.","family":"Khalil","sequence":"additional","affiliation":[{"name":"Fetal Medicine Unit, St George's University Hospitals NHS Foundation Trust University of London  London UK"},{"name":"Vascular Biology Research Centre, Molecular and Clinical Sciences Research Institute St George's University of London  London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"P. 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