{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,11]],"date-time":"2026-04-11T13:37:37Z","timestamp":1775914657647,"version":"3.50.1"},"reference-count":40,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2025,9,12]],"date-time":"2025-09-12T00:00:00Z","timestamp":1757635200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Ultrasound in Obstet &amp; Gyne"],"published-print":{"date-parts":[[2025,11]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To compare the maternal hemodynamics of Chinese women at low and at high risk for preterm pre\u2010eclampsia (PE) and assess the differences in hemodynamic parameters between high\u2010risk women with or without prophylactic aspirin.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      This was a prospective longitudinal case\u2013control study of 857 Chinese women with a singleton pregnancy who participated in the first\u2010trimester screen\u2010and\u2010prevent program for PE at the Prince of Wales Hospital, Hong Kong SAR, China, between February 2020 and March 2023. The risk of developing preterm PE (delivery before 37\u2009weeks) was determined using the Fetal Medicine Foundation combined test (maternal factors combined with mean arterial pressure (MAP), uterine artery pulsatility index and placental growth factor). The study population comprised three groups of women: (1) women at high risk (adjusted risk \u2265\u20091:100) for preterm PE who received 100\u2009mg or 160\u2009mg of aspirin according to maternal weight (&lt;\u200940\u2009kg or\u2009\u2265\u200940\u2009kg, respectively), starting before 16\u2009weeks' gestation until 36\u2009weeks' gestation, until delivery or until PE was diagnosed if before 36\u2009weeks; (2) women at high risk for preterm PE who did not receive aspirin; and (3) women at low risk (adjusted risk &lt;\u20091:100) for preterm PE who were matched 1:1 to high\u2010risk women, according to maternal age, weight and date of the scan. MAP was measured using a device validated for use in pregnancy, and heart rate (HR), stroke volume (SV), cardiac output (CO) and systemic vascular resistance\u00a0(SVR) were evaluated using two\u2010dimensional transthoracic echocardiography at 12\u2009+\u20090 to 15\u2009+\u20096\u2009weeks, 20\u2009+\u20090 to 24\u2009+\u20096\u2009weeks and 30\u2009+\u20090 to 37\u2009+\u20096\u2009weeks' gestation. Log\n                      <jats:sub>10<\/jats:sub>\n                      transformation was applied to fit the data to a Gaussian distribution. An adjusted multilevel linear mixed\u2010effects analysis was performed to compare the longitudinal changes of maternal hemodynamics across gestation between the three study groups.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      This study comprised 389 women at low risk of preterm PE, 379 women at high risk of preterm PE who received aspirin and 89 women at high risk who did not receive aspirin. There was no significant difference in the estimated marginal mean (EMmean) of log\n                      <jats:sub>10<\/jats:sub>\n                      HR across gestation among the three study groups. Compared with the low\u2010risk group, both high\u2010risk groups (with and without aspirin) exhibited consistently higher EMmean of log\n                      <jats:sub>10<\/jats:sub>\n                      MAP and log\n                      <jats:sub>10<\/jats:sub>\n                      SVR, and lower EMmean of log\n                      <jats:sub>10<\/jats:sub>\n                      CO and log\n                      <jats:sub>10<\/jats:sub>\n                      SV throughout gestation (all\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u20090.001). Although maternal hemodynamic trajectories differed across the EMmean of log\n                      <jats:sub>10<\/jats:sub>\n                      SV, CO, MAP and SVR between high\u2010risk women with aspirin and those without, there were no significant differences in these parameters between the two high\u2010risk groups.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>\n                      This study highlights the significant differences in maternal hemodynamic adaptation during pregnancy between Chinese women at high risk and those at low risk for preterm PE. Compared with low\u2010risk women, high\u2010risk women exhibited increased MAP and SVR, along with reduced SV and CO as early as the first trimester, and these alterations persisted throughout gestation. Notably, aspirin prophylaxis showed a limited effect on improving maternal hemodynamics in women at high risk for preterm PE, highlighting the need for alternative strategies to address the hemodynamic maladaptation in high\u2010risk women. \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.70027","type":"journal-article","created":{"date-parts":[[2025,9,12]],"date-time":"2025-09-12T22:03:22Z","timestamp":1757714602000},"page":"621-630","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Effect of aspirin on maternal hemodynamics in\n                    <scp>Chinese<\/scp>\n                    women at high risk for preterm pre\u2010eclampsia: longitudinal study"],"prefix":"10.1002","volume":"66","author":[{"ORCID":"https:\/\/orcid.org\/0009-0001-1219-6026","authenticated-orcid":false,"given":"X.","family":"Wang","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynecology, Nanchong Central Hospital The Second Clinical Medical College of North Sichuan Medical University  Sichuan China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"J.","family":"Lin","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology The Chinese University of Hong Kong  Hong Kong SAR China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Y.","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology The Chinese University of Hong Kong  Hong Kong SAR China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"I. S.","family":"Wong","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology The Chinese University of Hong Kong  Hong Kong SAR China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"J.","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology The Chinese University of Hong Kong  Hong Kong SAR China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"F.","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology The Chinese University of Hong Kong  Hong Kong SAR China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"S. L.","family":"Lau","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology The Chinese University of Hong Kong  Hong Kong SAR China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Q.","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Fujian Maternity and Child Health Hospital  Fujian China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"X.","family":"Xu","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Fujian Maternity and Child Health Hospital  Fujian China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3755-2701","authenticated-orcid":false,"given":"D. S.","family":"Sahota","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology The Chinese University of Hong Kong  Hong Kong SAR China"},{"name":"Shenzhen Research Institute The Chinese University of Hong Kong  Hong Kong SAR China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"A. P. W.","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Medicine &amp; Therapeutics, Prince of Wales Hospital The\u00a0Chinese University of Hong Kong  Hong Kong SAR China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3944-4130","authenticated-orcid":false,"given":"L. 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