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BJOG. 2016 Jun;123(7):1087-95. doi: 10.1111/1471-0528.13519. Epub 2015 Jul 14.

Fetal sex dependency of maternal vascular adaptation to pregnancy: a prospective population-based cohort study.

Author information

1
Department of Obstetrics and Gynaecology, Erasmus Medical Centre, Rotterdam, the Netherlands.
2
Department of Epidemiology, Erasmus Medical Centre, Rotterdam, the Netherlands.
3
Department of Paediatrics, Erasmus Medical Centre, Rotterdam, the Netherlands.

Abstract

OBJECTIVE:

To investigate fetal sex dependency of maternal vascular adaptation to pregnancy as assessed by uteroplacental vascular resistance and maternal blood pressure.

DESIGN:

Prospective population-based cohort study.

SETTING:

Rotterdam, the Netherlands.

POPULATION:

In total, 8224 liveborn singleton pregnancies were included.

METHODS:

Maternal vascular adaptation was assessed in all trimesters of pregnancy. Pregnancies were stratified into being either complicated by the placental syndrome (i.e. pre-eclampsia, fetal growth restriction or preterm birth, n = 1229) or uncomplicated (n = 6995).

MAIN OUTCOME MEASURES:

First trimester: blood pressures. Second trimester: blood pressures, pulsatility index of the uterine artery (PI-UtA). Third trimester: blood pressures, PI-UtA, presence of notching in the uterine artery.

RESULTS:

In women carrying a male fetus PI-UtA was higher than in women with a female fetus in the total group (second trimester P < 0.001, third trimester P = 0.005). Effect estimates differed between women with or without the placental syndrome. In the total group, women with a male fetus more often showed notching in the Doppler resistance pattern (odds ratio 1.42, 95% confidence interval 1.17-1.72). Different blood pressure patterns were observed between pregnant women with a male fetus and pregnant women with a female fetus and between complicated pregnancies and uncomplicated pregnancies.

CONCLUSION:

Fetal sex is significantly associated with maternal vascular adaptation to pregnancy with differential effects in uncomplicated pregnancies and in pregnancies complicated by the placental syndrome.

TWEETABLE ABSTRACT:

Fetal sex is significantly associated with maternal vascular adaptation to pregnancy.

KEYWORDS:

Blood pressure; fetal growth restriction; fetal sex; notching; pre-eclampsia; pulsatility index; spontaneous preterm birth

PMID:
26179828
DOI:
10.1111/1471-0528.13519
[Indexed for MEDLINE]
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