{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T07:08:18Z","timestamp":1788246498290,"version":"build-2803163510"},"reference-count":53,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2020,5,14]],"date-time":"2020-05-14T00:00:00Z","timestamp":1589414400000},"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":["BJOG"],"published-print":{"date-parts":[[2021,1]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>To describe maternal haemodynamic differences in gestational hypertension with small\u2010for\u2010gestational\u2010age babies (HDP\u00a0+\u00a0SGA), gestational hypertension with appropriate\u2010for\u2010gestational\u2010age babies (HDP\u2010only) and control pregnancies.<\/jats:p><\/jats:sec><jats:sec><jats:title>Design<\/jats:title><jats:p>Prospective cohort study.<\/jats:p><\/jats:sec><jats:sec><jats:title>Setting<\/jats:title><jats:p>Tertiary Hospital, UK.<\/jats:p><\/jats:sec><jats:sec><jats:title>Population<\/jats:title><jats:p>Women with gestational hypertension and healthy pregnant women.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Maternal haemodynamic indices were measured using a non\u2010invasive Ultrasound Cardiac Output Monitor (USCOM\u20101A<jats:sup>\u00ae<\/jats:sup>) and corrected for gestational age and maternal characteristics using device\u2010specific reference ranges.<\/jats:p><\/jats:sec><jats:sec><jats:title>Main outcome measures<\/jats:title><jats:p>Maternal cardiac output, stroke volume, systemic vascular resistance.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>We included 114 HDP\u00a0+\u00a0SGA, 202 HDP\u2010only and 401 control pregnancies at 26\u201341\u00a0weeks of gestation. There was no significant difference in the mean arterial blood pressure (110 versus 107\u00a0mmHg, <jats:italic>P<\/jats:italic>\u00a0=\u00a00.445) between the two HDP groups at presentation. Pregnancies complicated by HDP\u00a0+\u00a0SGA had significantly lower median heart rate (76 versus 85\u00a0bpm versus 83\u00a0bpm), lower cardiac output (0.85 versus 0.98 versus 0.97\u00a0MoM) and higher systemic vascular resistance (1.4 versus 1.0 versus 1.2\u00a0MoM) compared with control and HDP\u2010only pregnancies, respectively (all <jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00.05).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Women with HDP\u00a0+\u00a0SGA present with more severe haemodynamic dysfunction than HDP\u2010only. Even HDP\u2010only pregnancies exhibit impaired haemodynamic indices compared with normal pregnancies, supporting a role of the maternal cardiovascular system in gestational hypertension irrespective of fetal size. Central haemodynamic changes may play a role in the pathogenesis of pre\u2010eclampsia and should be considered alongside placental aetiology.<\/jats:p><\/jats:sec><jats:sec><jats:title>Tweetable abstract<\/jats:title><jats:p>Hypertensive disorders of pregnancy are associated with worse maternal haemodynamic function when associated with small\u2010for\u2010gestational\u2010age birth.<\/jats:p><\/jats:sec>","DOI":"10.1111\/1471-0528.16269","type":"journal-article","created":{"date-parts":[[2020,4,21]],"date-time":"2020-04-21T03:26:40Z","timestamp":1587439600000},"page":"167-175","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":23,"title":["Maternal haemodynamic function differs in pre\u2010eclampsia when it is associated with a small\u2010for\u2010gestational\u2010age newborn: a prospective cohort study"],"prefix":"10.1111","volume":"128","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0334-045X","authenticated-orcid":false,"given":"H","family":"Perry","sequence":"first","affiliation":[{"name":"Vascular Biology Research Centre, Molecular and Clinical Sciences Research Institute St George's University of London London UK"},{"name":"Fetal Medicine Unit Department of Obstetrics and Gynaecology St George's University Hospitals NHS Foundation Trust London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J","family":"Binder","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Feto\u2010maternal Medicine Medical University of Vienna Vienna Austria"},{"name":"Fetal Medicine Unit Department of Obstetrics and Gynaecology Medical University of Vienna Vienna Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4690-481X","authenticated-orcid":false,"given":"J","family":"Gutierrez","sequence":"additional","affiliation":[{"name":"Fetal Medicine Unit Department of Obstetrics and Gynaecology St George's University Hospitals NHS Foundation Trust London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"B","family":"Thilaganathan","sequence":"additional","affiliation":[{"name":"Vascular Biology Research Centre, Molecular and Clinical Sciences Research Institute St George's University of London London UK"},{"name":"Fetal Medicine Unit Department of Obstetrics and Gynaecology St George's University Hospitals NHS Foundation Trust London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A","family":"Khalil","sequence":"additional","affiliation":[{"name":"Vascular Biology Research Centre, Molecular and Clinical Sciences Research Institute St George's University of London London UK"},{"name":"Fetal Medicine Unit Department of Obstetrics and Gynaecology St George's University Hospitals NHS Foundation Trust London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2020,5,14]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2005.10.813"},{"key":"e_1_2_6_3_1","first-page":"1173","article-title":"Preconception cardiovascular risk factor differences between gestational hypertension and preeclampsia: Cohort Norway Study","volume":"2016","author":"Egeland GM","year":"1979","journal-title":"Hypertens (Dallas, Tex"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2014.07.055"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2015.11.024"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2018.08.034"},{"key":"e_1_2_6_7_1","first-page":"85","article-title":"Maternal cardiac dysfunction and remodeling in women with preeclampsia at term","volume":"2011","author":"Melchiorre K","year":"1979","journal-title":"Hypertens (Dallas, Tex)"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.3109\/10641955.2012.697951"},{"key":"e_1_2_6_9_1","first-page":"754","article-title":"Maternal cardiovascular function in normal pregnancy: evidence of maladaptation to chronic volume overload","volume":"2016","author":"Melchiorre K","year":"1979","journal-title":"Hypertens (Dallas, Tex)"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.j3078"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2015.12.047"},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.1161\/HYPERTENSIONAHA.114.04850"},{"key":"e_1_2_6_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.tcm.2018.04.009"},{"key":"e_1_2_6_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2016.02.003"},{"key":"e_1_2_6_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2016.05.047"},{"key":"e_1_2_6_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2017.02.015"},{"key":"e_1_2_6_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2018.04.002"},{"key":"e_1_2_6_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.preghy.2014.02.001"},{"key":"e_1_2_6_19_1","doi-asserted-by":"publisher","DOI":"10.1081\/PRG-120021060"},{"key":"e_1_2_6_20_1","first-page":"873","article-title":"Early and late preeclampsia: two different maternal hemodynamic states in the latent phase of the disease","volume":"2008","author":"Valensise H","year":"1979","journal-title":"Hypertens (Dallas, Tex)"},{"key":"e_1_2_6_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2015.08.003"},{"key":"e_1_2_6_22_1","first-page":"177","article-title":"The role of the spiral arteries in the pathogenesis of preeclampsia","volume":"1","author":"Brosens IA","year":"1972","journal-title":"Obstet Gynecol Ann"},{"key":"e_1_2_6_23_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2010.08.009"},{"key":"e_1_2_6_24_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2016.12.029"},{"key":"e_1_2_6_25_1","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9378(75)90522-0"},{"key":"e_1_2_6_26_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1471-0528.1986.tb07830.x"},{"key":"e_1_2_6_27_1","doi-asserted-by":"publisher","DOI":"10.1136\/heartjnl-2015-308476"},{"key":"e_1_2_6_28_1","doi-asserted-by":"publisher","DOI":"10.1093\/bja\/aei054"},{"key":"e_1_2_6_29_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjsurg.2008.07.039"},{"key":"e_1_2_6_30_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.15884"},{"key":"e_1_2_6_31_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.17287"},{"key":"e_1_2_6_32_1","unstructured":"Hypertension in pregnancy: diagnosis and management | Guidance and guidelines | NICE. [https:\/\/www.nice.org.uk\/guidance\/cg107\/chapter\/1\u2010guidance]. Accessed 1 November 2019."},{"key":"e_1_2_6_33_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1460-9592.2010.03480.x"},{"key":"e_1_2_6_34_1","doi-asserted-by":"publisher","DOI":"10.1177\/1751143715619186"},{"key":"e_1_2_6_35_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.15915"},{"key":"e_1_2_6_36_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.17504"},{"key":"e_1_2_6_37_1","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9378(89)90901-0"},{"key":"e_1_2_6_38_1","first-page":"1061","article-title":"Maternal hemodynamics in normal and preeclamptic pregnancies: a longitudinal study","volume":"76","author":"Easterling TR","year":"1990","journal-title":"Obstet Gynecol"},{"key":"e_1_2_6_39_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2018.07.029"},{"key":"e_1_2_6_40_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0002-9378(84)90357-0"},{"key":"e_1_2_6_41_1","doi-asserted-by":"publisher","DOI":"10.1161\/01.HYP.17.6.1072"},{"key":"e_1_2_6_42_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.18835"},{"key":"e_1_2_6_43_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2007.11.014"},{"key":"e_1_2_6_44_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2017.10.226"},{"key":"e_1_2_6_45_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.20231"},{"key":"e_1_2_6_46_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.19197"},{"key":"e_1_2_6_47_1","first-page":"S745","article-title":"Uterine and fetal placental Doppler indices are associated with maternal cardiovascular function","volume":"218","author":"Tay J","year":"2018","journal-title":"Am J Obstet Gynecol"},{"key":"e_1_2_6_48_1","doi-asserted-by":"publisher","DOI":"10.1016\/0028-2243(93)90265-E"},{"key":"e_1_2_6_49_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1479-828X.1999.tb03407.x"},{"key":"e_1_2_6_50_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2004.08.035"},{"key":"e_1_2_6_51_1","doi-asserted-by":"publisher","DOI":"10.1161\/HYPERTENSIONAHA.118.11092"},{"key":"e_1_2_6_52_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0002-9378(87)80172-2"},{"key":"e_1_2_6_53_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2013.12.029"},{"key":"e_1_2_6_54_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.322.7291.912"}],"container-title":["BJOG: An International Journal of Obstetrics &amp; Gynaecology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2F1471-0528.16269","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/1471-0528.16269","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/1471-0528.16269","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/1471-0528.16269","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,1]],"date-time":"2023-09-01T10:21:08Z","timestamp":1693563668000},"score":1,"resource":{"primary":{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/10.1111\/1471-0528.16269"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,5,14]]},"references-count":53,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2021,1]]}},"alternative-id":["10.1111\/1471-0528.16269"],"URL":"https:\/\/doi.org\/10.1111\/1471-0528.16269","archive":["Portico"],"relation":{},"ISSN":["1470-0328","1471-0528"],"issn-type":[{"value":"1470-0328","type":"print"},{"value":"1471-0528","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,5,14]]},"assertion":[{"value":"2020-04-14","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2020-05-14","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}