Association Between Uterine Artery Doppler and Severe Preeclampsia in Pregnancies Complicated by Late Preterm Fetal...

This study aimed to evaluate whether abnormal uterine artery Doppler (UtAD) indices are associated with increased risk of preeclampsia with severe features in pregnancies complicated by late preterm fetal growth restriction (FGR) and compare this association with that of abnormal umbilical artery Doppler (UAD) indices.

This retrospective cohort study included patients with singleton pregnancies complicated by FGR who underwent uterine and UAD assessment between 34⁰ and 36⁶ weeks gestation and delivered at hospitals within a large academic health system from 2018 to 2022. Abnormal UtAD was defined as a pulsatility index >95th percentile and/or the presence of notching; abnormal UAD was defined as a pulsatility index >95th percentile. The primary outcome was preeclampsia with severe features. Multivariable logistic regression using backward selection was performed to estimate adjusted ORs (aORs), controlling for maternal age and BMI.

Among 415 patients, 143 (34.5%) had abnormal UtAD and 28 (6.7%) had abnormal UAD. Severe preeclampsia occurred in 13.3% of patients with abnormal UtAD compared with 5.6% with normal indices (P = 0.01). In the adjusted models, abnormal UtAD was significantly associated with severe preeclampsia (aOR 2.12; 95% CI 1.03-4.36), whereas abnormal UAD was not (aOR 1.76; 95% CI 0.72-4.29).

Abnormal UtAD is independently associated with increased risk of preeclampsia with severe features in late preterm FGR pregnancies. UtAD may serve as a useful tool for risk stratification in this population.