Predicting Preeclampsia with Noninvasive Measures of Endothelial Dysfunction: A Pilot Study

Objective  This study evaluates the assessment of endothelial function and its prediction for preeclampsia among women with high-risk factors. Study Design  A prospective cohort study of 107 pregnant women at 20 weeks or greater gestation with risk factors for developing preeclampsia. Endothelial dysfunction was assessed using peripheral arterial tonometry by generating a reactive hyperemia index (RHI) score. An index score of <1.67 was defined as endothelial dysfunction. The primary outcome was preeclampsia. Logistic regression was used to predict preeclampsia from RHI scores, body mass index, gestational age at RHI evaluation, history of preeclampsia, history of pregestational diabetes mellitus, chronic hypertension, and fetal number. A receiver operating characteristic plot was constructed to predict preeclampsia from the RHI score. Results  Among 107 women, 99 had interpretable RHI scores. Among those with an abnormal RHI ( n  = 61), 17 (28%) developed preeclampsia. Among women with a normal score ( n  = 38), six (16%) developed preeclampsia ( p  = 0.166). After logistic regression, there was no significant association. A receiver operating characteristic plot also revealed no association between RHI score and preeclampsia. Conclusion  An abnormal RHI score using peripheral arterial tonometry indicating endothelial dysfunction was not predictive of developing preeclampsia in this cohort. Future studies are needed to further evaluate this relationship.