{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,12]],"date-time":"2026-06-12T15:05:32Z","timestamp":1781276732977,"version":"3.54.1"},"reference-count":32,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2025,1,15]],"date-time":"2025-01-15T00:00:00Z","timestamp":1736899200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100003123","name":"Fetal Medicine Foundation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100003123","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":[[2025,3]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Globally, one in four pregnant women is classified as overweight or obese, based on their prepregnancy body mass index (BMI). Obese pregnant women are at increased risk of adverse pregnancy outcomes and long\u2010term cardiovascular disease that occurs earlier in life. This study aimed to assess maternal hemodynamic and vascular parameters at 35\u201337\u2009weeks' gestation, to understand the alterations that may occur in association with increased maternal BMI and gestational weight gain, and to evaluate obesity\u2010related pregnancy outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      This was a prospective observational study of 11\u2009731 women with a singleton pregnancy attending for a routine hospital visit at 35\u2009+\u20090 to 36\u2009+\u20096\u2009weeks' gestation at King's College Hospital, London, UK, between December 2021 and June 2024. Women were categorized based on their BMI at 11\u201313\u2009weeks' gestation, as normal weight (BMI, 18.5\u201324.9\u2009kg\/m\n                      <jats:sup>2<\/jats:sup>\n                      ), overweight (BMI, 25.0\u201329.9\u2009kg\/m\n                      <jats:sup>2<\/jats:sup>\n                      ) or obese (BMI, \u2265\u200930\u2009kg\/m\n                      <jats:sup>2<\/jats:sup>\n                      ). We recorded details regarding maternal demographic characteristics and medical history, used Doppler ultrasound to assess the uterine artery pulsatility index (UtA\u2010PI) (as a marker for uteroplacental perfusion) and ophthalmic artery peak systolic velocity (PSV) ratio (as a marker for small vessel peripheral circulation), and measured carotid\u2010to\u2010femoral pulse\u2010wave velocity, augmentation index (as direct and indirect markers of aortic stiffness, respectively), cardiac output, total peripheral resistance (TPR), and central systolic and diastolic blood pressure. Multivariable analysis was performed to examine the relationship of BMI and gestational weight gain with hemodynamic and vascular measures, adjusting for maternal demographics, medical history, pregnancy characteristics and pregnancy outcomes (including pre\u2010eclampsia and gestational diabetes mellitus).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Overweight and obese women were more often of black ethnicity, and had higher central systolic and diastolic blood pressure, cardiac output, aortic stiffness and UtA\u2010PI, compared with normal\u2010weight women. There was no significant difference between overweight or obese women and normal\u2010weight women with regard to TPR and ophthalmic artery PSV ratio. On multivariable analysis, increasing BMI at 11\u201313\u2009weeks and gestational weight gain between 11\u201313\u2009weeks and 35\u201337\u2009weeks were independently associated with increases in all cardiovascular indices (including ophthalmic artery PSV ratio), apart from TPR.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>\n                      Women with a high BMI in early pregnancy\n                      <jats:italic>vs<\/jats:italic>\n                      normal\u2010weight women, and those with higher gestational weight gain, had worse maternal hemodynamic and vascular indices at 35\u201337\u2009weeks' gestation, independent of baseline and pregnancy characteristics. Our findings support the notion that optimization of prepregnancy weight and gestational weight gain may improve maternal hemodynamics and vascular function during pregnancy, and therefore may improve pregnancy outcomes. \u00a9 2025 The Author(s).\n                      <jats:italic>Ultrasound in Obstetrics &amp; Gynecology<\/jats:italic>\n                      published by John Wiley &amp; Sons Ltd on behalf of International Society of Ultrasound in Obstetrics and Gynecology.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/uog.29170","type":"journal-article","created":{"date-parts":[[2025,1,16]],"date-time":"2025-01-16T00:18:46Z","timestamp":1736986726000},"page":"303-310","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Association of maternal body mass index with hemodynamic and vascular alterations at 35\u201337 weeks' gestation"],"prefix":"10.1002","volume":"65","author":[{"given":"M.","family":"Charakida","sequence":"first","affiliation":[{"name":"Harris Birthright Research Centre for Fetal Medicine King's College Hospital  London UK"},{"name":"School of Biomedical Engineering and\u00a0Imaging Sciences King's College London  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5895-6887","authenticated-orcid":false,"given":"C.","family":"Chatzakis","sequence":"additional","affiliation":[{"name":"Harris Birthright Research Centre for Fetal Medicine King's College Hospital  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1355-610X","authenticated-orcid":false,"given":"L. A.","family":"Magee","sequence":"additional","affiliation":[{"name":"Institute of Women and Children's Health, School of Life Course and Population\u00a0Sciences King's College London  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5856-6072","authenticated-orcid":false,"given":"A.","family":"Syngelaki","sequence":"additional","affiliation":[{"name":"Harris Birthright Research Centre for Fetal Medicine King's College Hospital  London UK"},{"name":"Institute of Women and Children's Health, School of Life Course and Population\u00a0Sciences King's College London  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"T.","family":"Mansukhani","sequence":"additional","affiliation":[{"name":"Harris Birthright Research Centre for Fetal Medicine King's College Hospital  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"P.","family":"von Dadelszen","sequence":"additional","affiliation":[{"name":"Institute of Women and Children's Health, School of Life Course and Population\u00a0Sciences King's College London  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1266-0711","authenticated-orcid":false,"given":"K. 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