Fetal growth is associated with first-trimester maternal vascular function

Area of Science:

• Obstetrics and Gynecology
• Vascular Physiology
• Maternal-Fetal Medicine

Background:

• Maternal endothelial function is crucial for a healthy pregnancy.
• Early pregnancy assessment of vascular health may predict fetal growth outcomes.
• Understanding the relationship between maternal vasculature and fetal development is key.

Purpose of the Study:

• To investigate the association between first-trimester maternal vascular function and fetal growth.
• To assess vascular reactivity in both the brachial artery and forearm skin microcirculation.
• To determine if vascular dilatation capacity predicts birth-weight centile.

Main Methods:

• Vascular function assessed in 56 women (gestational weeks 11-14).
• Brachial artery reactivity measured by flow-mediated vasodilatation (FMD) and glyceryl trinitrate (GTN) response.
• Forearm skin microcirculation assessed using laser Doppler perfusion imaging with acetylcholine (ACh) and sodium nitroprusside (SNP).
• Fetal growth evaluated by birth-weight centile post-delivery.

Main Results:

• Both FMD and GTN-induced vasodilatation correlated with birth-weight centile.
• Endothelium-dependent (ACh) and -independent (SNP) microvascular reactivity also associated with birth-weight centile.
• Multivariate analysis confirmed these associations, with significant P-values and R-squared values for all measures.

Conclusions:

• First-trimester maternal vascular dilatation capacity, not solely endothelial function, is associated with fetal growth.
• These findings were consistent across both large artery (brachial) and microcirculation (forearm skin) assessments.
• Maternal vascular health in early pregnancy is a significant factor influencing fetal development.