{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,5]],"date-time":"2026-07-05T04:49:13Z","timestamp":1783226953493,"version":"3.54.6"},"reference-count":31,"publisher":"MDPI AG","issue":"9","license":[{"start":{"date-parts":[[2020,9,7]],"date-time":"2020-09-07T00:00:00Z","timestamp":1599436800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100013842","name":"Imperial Health Charity","doi-asserted-by":"publisher","award":["151612"],"award-info":[{"award-number":["151612"]}],"id":[{"id":"10.13039\/100013842","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000317","name":"Action Medical Research","doi-asserted-by":"publisher","award":["2450"],"award-info":[{"award-number":["2450"]}],"id":[{"id":"10.13039\/501100000317","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Agency for Innovation by Science and Technology","award":["131581"],"award-info":[{"award-number":["131581"]}]},{"DOI":"10.13039\/501100000272","name":"National Institute for Health Research","doi-asserted-by":"publisher","award":["146281"],"award-info":[{"award-number":["146281"]}],"id":[{"id":"10.13039\/501100000272","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>We investigate the relationship between maternal cardiovascular (CV) function and fetal Doppler changes in healthy pregnancies and those with pre-eclampsia (PE), small for gestational age (SGA) or fetal growth restriction (FGR). This was a three-centre prospective study, where CV assessment was performed using inert gas rebreathing, continuous Doppler or impedance cardiography. Maternal cardiac output (CO) and peripheral vascular resistance (PVR) were analysed in relation to the uterine artery, umbilical artery (UA) and middle cerebral artery (MCA) pulsatility indices (PI, expressed as z-scores by gestational week) using polynomial regression analyses, and in relation to the presence of absent\/reversed end diastolic (ARED) flow in the UA. We included 81 healthy controls, 47 women with PE, 65 with SGA\/FGR and 40 with PE + SGA\/FGR. Maternal CO was inversely related to fetal UA PI and positively related to MCA PI; the opposite was observed for PVR, which was also positively associated with increased uterine artery impedance. CO was lower (z-score 97, p = 0.02) and PVR higher (z-score 2.88, p = 0.02) with UA ARED flow. We report that maternal CV dysfunction is associated with fetal vascular changes, namely raised impedance in the fetal-placental circulation and low impedance in the fetal cerebral vessels. These findings are most evident with critical UA Doppler changes and represent a potential mechanism for therapeutic intervention.<\/jats:p>","DOI":"10.3390\/jcm9092891","type":"journal-article","created":{"date-parts":[[2020,9,7]],"date-time":"2020-09-07T09:18:16Z","timestamp":1599470296000},"page":"2891","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":22,"title":["Maternal Cardiovascular Dysfunction is Associated with Hypoxic Cerebral and Umbilical Doppler Changes"],"prefix":"10.3390","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9938-9869","authenticated-orcid":false,"given":"Giulia","family":"Masini","sequence":"first","affiliation":[{"name":"Centre for Fetal Care, Queen Charlotte\u2019s and Chelsea Hospital, Imperial College Healthcare NHS Trust, London W12 0HS, UK"},{"name":"Fetal Medicine Unit, Careggi University Hospital, 50134 Florence, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jasmine","family":"Tay","sequence":"additional","affiliation":[{"name":"Centre for Fetal Care, Queen Charlotte\u2019s and Chelsea Hospital, Imperial College Healthcare NHS Trust, London W12 0HS, UK"},{"name":"Institute for Reproductive and Developmental Biology, Department of Metabolism, Digestion and Reproduction, Imperial College London, London W12 0HS, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carmel M","family":"McEniery","sequence":"additional","affiliation":[{"name":"Division of Experimental Medicine and Immunotherapeutics, University of Cambridge, Cambridge CB2 0QQ, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ian B","family":"Wilkinson","sequence":"additional","affiliation":[{"name":"Division of Experimental Medicine and Immunotherapeutics, University of Cambridge, Cambridge CB2 0QQ, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4764-544X","authenticated-orcid":false,"given":"Herbert","family":"Valensise","sequence":"additional","affiliation":[{"name":"Department of Surgery, Division of Obstetrics and Gynecology, Policlinico Casilino, Tor Vergata, University of Rome, 00169 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Grazia M","family":"Tiralongo","sequence":"additional","affiliation":[{"name":"Department of Surgery, Division of Obstetrics and Gynecology, Policlinico Casilino, Tor Vergata, University of Rome, 00169 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniele","family":"Farsetti","sequence":"additional","affiliation":[{"name":"Department of Surgery, Division of Obstetrics and Gynecology, Policlinico Casilino, Tor Vergata, University of Rome, 00169 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5778-434X","authenticated-orcid":false,"given":"Wilfried","family":"Gyselaers","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Ziekenhuis Oost Limburg, Schiepse Bos 6, 3600 Genk, Belgium"},{"name":"Department of Physiology, Hasselt University, Agoralaan, 3590 Diepenbeek, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sharona","family":"Vonck","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Ziekenhuis Oost Limburg, Schiepse Bos 6, 3600 Genk, Belgium"},{"name":"Faculty of Medicine and Life Sciences, Hasselt University, Agoralaan, 3590 Diepenbeek, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christoph C.","family":"Lees","sequence":"additional","affiliation":[{"name":"Centre for Fetal Care, Queen Charlotte\u2019s and Chelsea Hospital, Imperial College Healthcare NHS Trust, London W12 0HS, UK"},{"name":"Institute for Reproductive and Developmental Biology, Department of Metabolism, Digestion and Reproduction, Imperial College London, London W12 0HS, UK"},{"name":"Department of Development and Regeneration, KU Leuven, 3000 Leuven, Belgium"},{"name":"Centre for Fetal Care, Queen Charlotte\u2019s and Chelsea Hospital, Du Cane Road, London W12 0HS, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2020,9,7]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"849","DOI":"10.1097\/HJH.0000000000000090","article-title":"A longitudinal study of maternal cardiovascular function from preconception to the postpartum period","volume":"32","author":"Mahendru","year":"2014","journal-title":"J. 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