{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,31]],"date-time":"2026-07-31T20:06:54Z","timestamp":1785528414002,"version":"3.56.0"},"reference-count":56,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2025,12,31]],"date-time":"2025-12-31T00:00:00Z","timestamp":1767139200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2025,12,31]],"date-time":"2025-12-31T00:00:00Z","timestamp":1767139200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Acta Obstet Gynecol Scand"],"published-print":{"date-parts":[[2026,2]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Abnormalities in central hemodynamic functions before and throughout pregnancy may antedate impaired fetal growth. We aimed to assess cardiac output (CO) and total peripheral vascular resistance (TPVR) trajectories throughout singleton pregnancies with and without impaired fetal growth by systematic review and meta\u2010analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Material and Methods<\/jats:title>\n                    <jats:p>PubMed and Embase were systematically searched (inception \u2013 July 2023), and reference lists were screened. Studies reporting CO and TPVR during singleton pregnancies complicated by impaired fetal growth were included. Studies measuring hemodynamic parameters in women with prepregnancy hypertension and\/or cardiac diseases were excluded. Absolute values of hemodynamic parameters were calculated over pregnancy using a random\u2010effects model, and subgroup analyses differentiated more severe clinical phenotypes of impaired fetal growth. The systematic review was registered in the PROSPERO database (CRD42020172252).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Thirty\u2010three studies were included, comprising 7816 women. Hemodynamic function in non\u2010pregnant women did not differ between those who subsequently gave birth to a growth\u2010restricted neonate or an appropriately grown neonate. Pregnancies complicated by impaired fetal growth were accompanied by elevated second and third\u2010trimester TPVR and concurrent reduced third\u2010trimester CO. Second and third\u2010trimester TPVR was consistently higher when fetal growth restriction was accompanied by abnormal perfusion indices instead of only low birthweight (centile), concurrent maternal hypertensive disorder of pregnancy, and when small for gestational age was accompanied by preterm birth.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Impaired fetal growth is associated with increased vascular resistance and reduced CO from the second trimester onwards. More severe phenotypes, particularly those with attenuated placental perfusion or lower gestational age at birth, exhibit the most vasoconstrictive hemodynamic profile. Future studies could focus on targeted preventive measures to restore hemodynamic function.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/aogs.70102","type":"journal-article","created":{"date-parts":[[2025,12,31]],"date-time":"2025-12-31T11:41:40Z","timestamp":1767181300000},"page":"215-224","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Hemodynamic changes in pregnancies with impaired fetal growth: A systematic review and meta\u2010analysis"],"prefix":"10.1111","volume":"105","author":[{"ORCID":"https:\/\/orcid.org\/0009-0007-3555-5216","authenticated-orcid":false,"given":"Britt M. J. G.","family":"Kempener","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynecology Maastricht University Medical Centre  Maastricht the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4513-163X","authenticated-orcid":false,"given":"Laura M.","family":"Jorissen","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Maastricht University Medical Centre  Maastricht the Netherlands"},{"name":"GROW\u2014School for Oncology and Developmental Biology Maastricht University  Maastricht the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eva G.","family":"Mulder","sequence":"additional","affiliation":[{"name":"GROW\u2014School for Oncology and Developmental Biology Maastricht University  Maastricht the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chahinda","family":"Ghossein\u2010Doha","sequence":"additional","affiliation":[{"name":"GROW\u2014School for Oncology and Developmental Biology Maastricht University  Maastricht the Netherlands"},{"name":"Cardiovascular Research Institute Maastricht (CARIM) Maastricht University  Maastricht the Netherlands"},{"name":"Department of Cardiology Erasmus University Medical Centre  Rotterdam the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joris","family":"van Drongelen","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Radboud University Medical Centre  Nijmegen the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ralph R.","family":"Scholten","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Radboud University Medical Centre  Nijmegen the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christoph C.","family":"Lees","sequence":"additional","affiliation":[{"name":"Centre for Fetal Care, Queen Charlotte's and Chelsea Hospital Imperial College Healthcare NHS Trust  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sander","family":"de Haas","sequence":"additional","affiliation":[{"name":"GROW\u2014School for Oncology and Developmental Biology Maastricht University  Maastricht the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6916-7261","authenticated-orcid":false,"given":"Emma B. N. J.","family":"Janssen","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Maastricht University Medical Centre  Maastricht the Netherlands"},{"name":"GROW\u2014School for Oncology and Developmental Biology Maastricht University  Maastricht the Netherlands"},{"name":"Cardiovascular Research Institute Maastricht (CARIM) Maastricht University  Maastricht the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marc E. A.","family":"Spaanderman","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Maastricht University Medical Centre  Maastricht the Netherlands"},{"name":"GROW\u2014School for Oncology and Developmental Biology Maastricht University  Maastricht the Netherlands"},{"name":"Department of Obstetrics and Gynecology Radboud University Medical Centre  Nijmegen the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,12,31]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.17360"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/1471-0528.16678"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.17368"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehq200"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2007.03.027"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.22134"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.0000015699.48605.08"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.1161\/hc3001.093437"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2014-1143"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0000000000002209"},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.1136\/adc.80.4.305"},{"key":"e_1_2_11_13_1","doi-asserted-by":"publisher","DOI":"10.1007\/s001250050086"},{"key":"e_1_2_11_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.preghy.2021.12.004"},{"key":"e_1_2_11_15_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.20137"},{"key":"e_1_2_11_16_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.17431"},{"key":"e_1_2_11_17_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12884-020-03150-0"},{"key":"e_1_2_11_18_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.n71"},{"key":"e_1_2_11_19_1","doi-asserted-by":"publisher","DOI":"10.1007\/978-1-4419-7073-2_17"},{"key":"e_1_2_11_20_1","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2288-5-13"},{"key":"e_1_2_11_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cct.2015.09.002"},{"key":"e_1_2_11_22_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.0006-341X.2000.00455.x"},{"key":"e_1_2_11_23_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.315.7109.629"},{"key":"e_1_2_11_24_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.327.7414.557"},{"key":"e_1_2_11_25_1","unstructured":"G. S. meta: General Package for Meta\u2010Analysis.2015.https:\/\/CRAN.R\u2010project.org\/package=meta"},{"key":"e_1_2_11_26_1","volume-title":"R: A Language and Environment for Statistical Computing","author":"Team RC","year":"2015"},{"key":"e_1_2_11_27_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0206257"},{"key":"e_1_2_11_28_1","doi-asserted-by":"publisher","DOI":"10.3109\/14767058.2013.871700"},{"key":"e_1_2_11_29_1","doi-asserted-by":"publisher","DOI":"10.1159\/000495507"},{"key":"e_1_2_11_30_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.preghy.2017.05.003"},{"key":"e_1_2_11_31_1","doi-asserted-by":"publisher","DOI":"10.1089\/ham.2022.0082"},{"key":"e_1_2_11_32_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2007.11.014"},{"key":"e_1_2_11_33_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0002-9378(97)70572-6"},{"key":"e_1_2_11_34_1","doi-asserted-by":"publisher","DOI":"10.1111\/bph.13614"},{"key":"e_1_2_11_35_1","doi-asserted-by":"publisher","DOI":"10.1067\/mob.2000.106750"},{"key":"e_1_2_11_36_1","doi-asserted-by":"publisher","DOI":"10.1097\/00004872-199307000-00008"},{"key":"e_1_2_11_37_1","doi-asserted-by":"publisher","DOI":"10.1161\/HYPERTENSIONAHA.118.11092"},{"key":"e_1_2_11_38_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(83)91970-0"},{"key":"e_1_2_11_39_1","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0b013e318213cd31"},{"key":"e_1_2_11_40_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1523-1755.2001.00943.x"},{"key":"e_1_2_11_41_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.17316"},{"issue":"6","key":"e_1_2_11_42_1","first-page":"1029","article-title":"Maternal plasma volume expansion and hormonal changes in women with idiopathic fetal growth retardation","volume":"81","author":"Salas SP","year":"1993","journal-title":"Obstet Gynecol"},{"key":"e_1_2_11_43_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1471-0528.1982.tb04676.x"},{"key":"e_1_2_11_44_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2017.11.577"},{"key":"e_1_2_11_45_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.AOG.0000118310.51730.2d"},{"key":"e_1_2_11_46_1","doi-asserted-by":"publisher","DOI":"10.1080\/14767058.2022.2056443"},{"key":"e_1_2_11_47_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2017.12.003"},{"key":"e_1_2_11_48_1","doi-asserted-by":"publisher","DOI":"10.1159\/000359969"},{"key":"e_1_2_11_49_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.6368"},{"key":"e_1_2_11_50_1","doi-asserted-by":"publisher","DOI":"10.5858\/arpa.2015-0225-CC"},{"key":"e_1_2_11_51_1","first-page":"33","article-title":"Worsening of the uterine artery Doppler is associated with the development of hypertensive disorders of pregnancy","volume":"124","author":"Binder JMC","year":"2017","journal-title":"BJOG\u2014Int J Obstet Gynaecol"},{"key":"e_1_2_11_52_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.20419"},{"key":"e_1_2_11_53_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2016.10.016"},{"key":"e_1_2_11_54_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2016.09.076"},{"key":"e_1_2_11_55_1","doi-asserted-by":"publisher","DOI":"10.1161\/HYPERTENSIONAHA.120.16502"},{"key":"e_1_2_11_56_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.5234"},{"key":"e_1_2_11_57_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12884-019-2456-7"}],"container-title":["Acta Obstetricia et Gynecologica Scandinavica"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/aogs.70102","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/aogs.70102","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/aogs.70102","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,2,14]],"date-time":"2026-02-14T10:14:48Z","timestamp":1771064088000},"score":1,"resource":{"primary":{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/10.1111\/aogs.70102"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,12,31]]},"references-count":56,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2026,2]]}},"alternative-id":["10.1111\/aogs.70102"],"URL":"https:\/\/doi.org\/10.1111\/aogs.70102","archive":["Portico"],"relation":{},"ISSN":["0001-6349","1600-0412"],"issn-type":[{"value":"0001-6349","type":"print"},{"value":"1600-0412","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,12,31]]},"assertion":[{"value":"2025-04-28","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-11-05","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-12-31","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}