Multi-parameter echocardiographic assessment predicted adverse pregnancy outcomes in women ≥35 years with PIHS with an AUC of 0.925, demonstrating excellent discriminatory performance.
Observational (n=240)
Single-blind (echocardiographer blinded to outcomes)
No
Do multi-parameter echocardiographic indicators predict adverse pregnancy outcomes in women of advanced maternal age with pregnancy-induced hypertension syndrome?
Multi-parameter echocardiographic assessment, particularly markers of diastolic dysfunction and elevated left atrial pressure, provides high predictive value for identifying adverse pregnancy outcomes in older women with pregnancy-induced hypertension.
Effect estimate: Model AUC 0.925 (95% CI 95% CI 0.872–0.989)
Absolute Event Rate: 23.75% vs 76.25%
p-value: p=<0.05
Introduction Hypertensive disorders of pregnancy are a major cause of maternal and perinatal morbidity and mortality, particularly among women of advanced maternal age. Materials and methods This retrospective study evaluated the correlation between echocardiographic parameters and adverse pregnancy outcomes in 240 women aged ≥35 years diagnosed with pregnancy-induced hypertension syndrome (PIHS) from February 2019 to June 2022. Patients were classified into a favorable outcome group ( n = 183) and an adverse outcome group ( n = 57). Echocardiographic indicators—including ejection fraction (EF), stroke volume (SV), cardiac output (CO), E/A ratio, early diastolic mitral annular velocity (E′), E/E′ ratio, left atrial volume index (LAVI), pulmonary venous flow velocities (S-, D-, Ar-waves), and myocardial performance (Tei) index—were compared between groups. Results Women with adverse outcomes had significantly lower EF, SV, CO, E/A ratio, and E′, while showing higher E/E′, LAVI, Ar-wave velocity, and Tei index, with reduced S- and D-wave velocities (all p 0.001). A history of hypertension, nephritis, and a family history of hypertension were also identified as significant clinical risk factors. Multivariable logistic regression confirmed that both clinical and echocardiographic parameters were independently associated with poor outcomes. Receiver operating characteristic analysis demonstrated high discriminative power for key indices (AUC range: 0.78–0.90), and a combined model integrating multiple echocardiographic variables achieved an AUC of 0.925, indicating excellent predictive performance. Discussion These findings suggest that multi-parameter echocardiographic assessment provides a reliable, non-invasive approach for identification of high-risk PIHS patients, supporting more effective monitoring and timely intervention to improve maternal and fetal prognosis.
Zhong et al. (Wed,) conducted a observational in Pregnancy-induced hypertension syndrome in women of advanced maternal age (n=240). Multi-parameter echocardiographic assessment vs. None (observational comparison between favorable vs adverse pregnancy outcome groups) was evaluated on Adverse pregnancy outcomes defined as stillbirth ≥20 weeks, fetal demise, preterm birth (<37 weeks), or fetal growth restriction (<10th percentile) (Model AUC 0.925, 95% CI 95% CI 0.872–0.989, p=<0.05). Multi-parameter echocardiographic assessment predicted adverse pregnancy outcomes in women ≥35 years with PIHS with an AUC of 0.925, demonstrating excellent discriminatory performance.