Linking maternal and neonatal circulation in preeclampsia.

Area of Science:

• Cardiovascular Physiology
• Maternal-Fetal Medicine
• Neonatology

Background:

• Hypertensive disorders of pregnancy (HDP), especially early-onset preeclampsia (EOPE), significantly contribute to perinatal complications.
• While placental dysfunction is a known factor, maternal cardiovascular dysfunction's role in neonatal circulatory transition is less understood.

Purpose of the Study:

• To investigate the association between maternal hemodynamic parameters and neonatal circulatory transition in pregnancies with EOPE.
• To explore the influence of maternal cardiovascular function on neonatal cardiac output and systemic vascular resistance.

Main Methods:

• Prospective study of mother-infant pairs with EOPE.
• Maternal echocardiography and neonatal continuous hemodynamic monitoring using electrical cardiometry.
• Correlation analysis and generalized linear mixed-effects models (GLMM) adjusted for covariates.

Main Results:

• Maternal systolic function indices (cardiac output, ejection fraction) were inversely correlated with neonatal cardiac output.
• Maternal ejection fraction showed a positive association with neonatal systemic vascular resistance, particularly before accounting for patent ductus arteriosus.
• Maternal systolic impairment correlated with increased neonatal cardiac output, indicating neonatal compensation.

Conclusions:

• Maternal systolic dysfunction in EOPE is associated with a compensatory increase in neonatal cardiac output.
• Neonatal vascular tone changes were minimal despite maternal hemodynamic alterations.
• Findings support integrated cardiovascular assessment in pregnancies with hypertensive disorders.