Brachial Artery Flow Mediated Dilation in the First Trimester to Predict the Occurrence of Hypertensive Disorders during Pregnancy

Objectives: To determine whether brachial artery flow-mediated dilation (FMD) assessed by ultrasonography during the late first trimester is able to predict the occurrence of hypertensive disorders during pregnancy. Methods: Maternal endothelial function was assessed by flow-mediated dilation (FMD) of the brachial artery in 487 pregnant women at 11-13(+6) weeks' gestation. Subjects were prospectively followed and grouped according to the outcomes related to hypertensive disorders. We determined the areas under receiver operating characteristic (ROC) curve with their respective 95% confidence intervals (CI) for using low FMD results to predict the occurrence of hypertensive disorders during pregnancy. Results: Among 487 women, 9(1.8%) were diagnosed with early-onset preeclampsia, 22 (4.5%) were diagnosed with late-onset preeclampsia, 47 (9.7%) developed gestational hypertension, and the remaining 409 (84%) pregnancies were unaffected by hypertensive disorders. Area under ROC curve analyses demonstrated that FMD was not able to predict pregnancies that developed hypertensive disorders. Conclusions: We conclude that FMD should not be considered a potential first-trimester marker of hypertensive disorders during pregnancy. (C) 2015 S. Karger AG, Basel