The relationship between endothelial function in women with isolated preeclampsia, IUGR and gestational hypertension

Purpose: Women with pregnancy complications such as intrauterine growth restriction (IUGR), preeclampsia (PE) or gestational hypertension (GH) are at increased risk for cardiovascular diseases in later life. Impaired endothalial function is reported in patients with cardiovascular disease and in patients following preeclampsia but not with gestational hypertension. The aim of this study was to evaluate endothelial function (EF) during pregnancy in isolated PE, IUGR and GH. Material and methods: Flow-mediated-diatation (FMD) of the brachial artery was measured with high resolution ultrasound to assess EF in 51 non-pregnant controls, 43 healthy pregnant women, 28 women with IUGR and absence of PE or gestational hypertension (GH), 42 women with PE without IUGR, and in 22 women with GH in absence of IUGR. Results: In HP a high FMD remaining stable throughout gestation was noted. After delivery FMD dropped to nonpregnant levels (NP). Women with PE had decreased FMD during pregnancy compared to HP, whereas FMD in IUGR and GH was not significantly different in comparison to HP (table 1). Tab. 1 FMD (%; mean ± SD) NP PE GH IUGR HP 1st trimester 4.7 ± 5.1 * 7.3 ± 4.4 13.0 ± 10.9 12.0 ± 7.3 # 2nd trimester 5.2 ± 5.5 * 8.4 ± 6.4 13.7 ± 7.3 # 11.9 ± 9.7 # 3 rd trimester 3.4 ± 5.5 *# 9.4 ± 4.4 # 9.3 ± 7.0 # 12.1 ± 9.7 # Postpartum 6.2 ± 3.9 3.7 ± 3.6 # 10.8 ± 10.6 7.9 ± 4.3 5.5 ± 2.1 *= p < 0.05 versus HP # 0 p < 0.05 versus NP Conclusion: Significantly impaired endothelial function is only present in women with isolated preeclampsia but not with isolated gestational hypertension or IUGR and can be found as early as 1st trimester. These findings imply that dysfunctional endothelium does not contribute to GH and IUGR as much as it does in PE.