{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,2,25]],"date-time":"2025-02-25T00:10:11Z","timestamp":1740442211767,"version":"3.37.3"},"reference-count":33,"publisher":"Georg Thieme Verlag KG","issue":"04","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Am J Perinatol"],"published-print":{"date-parts":[[2025,3]]},"abstract":"<jats:p>\n            Objective\u2003This study aimed to (1) evaluate whether endothelial dysfunction, as measured by peripheral arterial tonometry (PAT) indices and biomarker (soluble fms-like tyrosine kinase-1 [sFLT], brain natriuretic peptide [BNP]) levels at 34 weeks gestation, can predict progression from nonsevere to severe hypertensive disorders of pregnancy (HDPs); and (2) develop a clinical risk model for prediction of progression from nonsevere to severe HDP.<\/jats:p><jats:p>\n            Study Design\u2003We prospectively enrolled patients with a singleton gestation carrying a nonsevere HDP diagnosis. Forty-five participants were enrolled for PAT evaluation and serum collection between 340\/7 and 366\/7 weeks. PAT indices (e.g., Augmentation Index normalized to a heart rate of 75\u2009bpm [AI75]) and biomarker concentrations were assessed at enrollment. The primary outcome was progression from a nonsevere diagnosis in the late preterm period to a diagnosis of preeclampsia with severe features or superimposed preeclampsia. Statistical analyses included two-sample t-tests, Fisher's exact tests, and multivariate modeling.<\/jats:p><jats:p>\n            Results\u2003Thirteen subjects (30%) progressed to severe disease. No significant differences in mean PAT indices between the outcome groups were found. We found a significant difference in mean sFLT values between the two groups (p\u2009=\u20090.02, area under the curve [AUC] of 0.609), but not in mean BNP values. An endothelial dysfunction index (presence of fetal growth restriction, \u201chigh\u201d AI75, and positive systolic blood pressure slope) discriminated between progression and nonprogression (p\u2009=\u20090.03, AUC of 0.707).<\/jats:p><jats:p>\n            Conclusion\u2003sFLT level was a marker of progression from nonsevere to severe HDP. Further, a novel endothelial dysfunction index discriminated between progression and nonprogression to severe disease with good performance.<\/jats:p><jats:p>\n            Key Points\n          <\/jats:p>","DOI":"10.1055\/a-2407-1761","type":"journal-article","created":{"date-parts":[[2024,9,30]],"date-time":"2024-09-30T22:41:57Z","timestamp":1727736117000},"page":"511-519","source":"Crossref","is-referenced-by-count":0,"title":["Can Peripheral Arterial Tonometry and Biomarkers Help Identify Women Who Will Have Progressively Worsening Hypertensive Disorders of Pregnancy?"],"prefix":"10.1055","volume":"42","author":[{"given":"Caitlin M.","family":"Clifford","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, University of Michigan, Ann Arbor, Michigan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ashley M.","family":"Hesson","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, University of Michigan, Ann Arbor, Michigan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ajleeta","family":"Sangtani","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, University of Michigan, Ann Arbor, Michigan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Santhi K.","family":"Ganesh","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, University of Michigan, Ann Arbor, Michigan"},{"name":"Department of Human Genetics, University of Michigan, Ann Arbor, Michigan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elizabeth S.","family":"Langen","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, University of Michigan, Ann Arbor, Michigan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"194","published-online":{"date-parts":[[2024,9,30]]},"reference":[{"issue":"06","key":"ref1","doi-asserted-by":"crossref","first-page":"e237","DOI":"10.1097\/AOG.0000000000003891","article-title":"Gestational Hypertension and Preeclampsia: ACOG Practice Bulletin, Number 222","volume":"135","author":"American College of Obstetricians and Gynecologists' Committee on Practice Bulletins-Obstetrics","year":"2020","journal-title":"Obstet Gynecol"},{"issue":"03","key":"ref2","doi-asserted-by":"crossref","first-page":"237","DOI":"10.1016\/j.ajog.2017.04.032","article-title":"Short-term costs of preeclampsia to the United States health care system","volume":"217","author":"W Stevens","year":"2017","journal-title":"Am J Obstet Gynecol"},{"issue":"03","key":"ref3","doi-asserted-by":"crossref","first-page":"130","DOI":"10.1053\/j.semperi.2009.02.010","article-title":"The global impact of pre-eclampsia and 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