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Objective <p>To explore the predictive value of second-trimester ankle-brachial pulse wave velocity (baPWV) and the soluble fms-like tyrosine kinase−1 to placental growth factor ratio(sFlt−1/PlGF) for adverse pregnancy outcomes among women with chronic hypertension in pregnancy.</p> Methods <p>This prospective cohort study consecutively enrolled pregnant women with chronic hypertension. BaPWV and sFlt-1/PlGF were measured at 22–26 weeks of gestation. The observed pregnancy outcomes included pre-eclampsia (PE), gestational age at delivery, newborn birth weight, preterm birth and small for gestational age (SGA).</p> Results <p>A total of 206 pregnant women with chronic hypertension were enrolled, of whom 108 (52.43%) developed PE. BaPWV did not differ significantly between women who developed PE and those who did not. However, women who subsequently delivered preterm or gave birth to SGA infants had significantly higher baPWV than those without these outcomes (<i>P</i> &lt; 0.001 and <i>P</i> = 0.001). BaPWV was negatively correlated with both gestational age at delivery (<i>r</i> = -0.324, <i>P</i> &lt; 0.001) and neonatal birth weight ( r = །0.26, <i>P</i> = 0.002). Multivariate logistic regression analysis identified elevated baPWV as an independent risk factor for both preterm birth (OR = 2.62, 95% CI: 1.48–4.63, <i>P</i> &lt; 0.001) and SGA (OR = 1.18, 95% CI: 1.08–3.03, <i>P</i> = 0.024). Receiver operating characteristic curve analysis showed that baPWV alone yielded moderate predictive accuracy for preterm birth (AUC = 0.77, 95% CI: 0.69–0.86) and SGA (AUC = 0.72, 95% CI: 0.63–0.81). The combination of baPWV and the sFlt-1/PlGF ratio improved predictive performance, the corresponding AUC values rose to 0.87 (95% CI: 0.79–0.95) for preterm delivery and 0.78 (95% CI: 0.68–0.87) for SGA, respectively.</p> Conclusion <p>Elevated mid-trimester baPWV in pregnant women with chronic hypertension is an independent predictor of preterm birth and SGA. The combination of baPWV and the angiogenic marker sFlt-1/PlGF improves predictive accuracy.</p>

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The predictive value of mid-trimester baPWV combined with sFlt-1/PlGF for the adverse pregnancy outcomes of pregnant women with chronic hypertension: a prospective cohort study

  • 期刊论文

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  • 发表日期：

    2026年7月13日

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  • Lin Zhang,
  • Hong Gao,
  • Tong Tong,
  • Tao Sun,
  • Guochang Chen,
  • Yu Wang,
  • Tingting Jiang

摘要

Objective

To explore the predictive value of second-trimester ankle-brachial pulse wave velocity (baPWV) and the soluble fms-like tyrosine kinase−1 to placental growth factor ratio(sFlt−1/PlGF) for adverse pregnancy outcomes among women with chronic hypertension in pregnancy.

Methods

This prospective cohort study consecutively enrolled pregnant women with chronic hypertension. BaPWV and sFlt-1/PlGF were measured at 22–26 weeks of gestation. The observed pregnancy outcomes included pre-eclampsia (PE), gestational age at delivery, newborn birth weight, preterm birth and small for gestational age (SGA).

Results

A total of 206 pregnant women with chronic hypertension were enrolled, of whom 108 (52.43%) developed PE. BaPWV did not differ significantly between women who developed PE and those who did not. However, women who subsequently delivered preterm or gave birth to SGA infants had significantly higher baPWV than those without these outcomes (P < 0.001 and P = 0.001). BaPWV was negatively correlated with both gestational age at delivery (r = -0.324, P < 0.001) and neonatal birth weight ( r = །0.26, P = 0.002). Multivariate logistic regression analysis identified elevated baPWV as an independent risk factor for both preterm birth (OR = 2.62, 95% CI: 1.48–4.63, P < 0.001) and SGA (OR = 1.18, 95% CI: 1.08–3.03, P = 0.024). Receiver operating characteristic curve analysis showed that baPWV alone yielded moderate predictive accuracy for preterm birth (AUC = 0.77, 95% CI: 0.69–0.86) and SGA (AUC = 0.72, 95% CI: 0.63–0.81). The combination of baPWV and the sFlt-1/PlGF ratio improved predictive performance, the corresponding AUC values rose to 0.87 (95% CI: 0.79–0.95) for preterm delivery and 0.78 (95% CI: 0.68–0.87) for SGA, respectively.

Conclusion

Elevated mid-trimester baPWV in pregnant women with chronic hypertension is an independent predictor of preterm birth and SGA. The combination of baPWV and the angiogenic marker sFlt-1/PlGF improves predictive accuracy.