Alterations in maternal arterial stiffness and maternal and fetal doppler measurements in pregnancy complicated by fetal growth restriction

Figures

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  Fig. 1. Flow chart for participant selection with inclusion and exclusion criteria

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  Fig. 2. Correlations between gestational age and Doppler measurements. A UtA PI, B UtA-TAMX, C UA PI, D UA-PSV, E MCA PI, and F MCA-PSV. Doppler measurements from the control, early-onset FGR, and late-onset FGR groups were analyzed using linear regression analysis (with the exception of the MCA PI in the control group, which was modeled using the restricted cubic spline function). The deep red lines represent the reference ranges for normal values, including the 5th, 50th, and 95th percentiles for the MCA PI, mean UtA PI and mean UA PI. PI, pulsatility index; UtA, uterine artery; UA, umbilical artery; MCA, middle cerebral artery; TAMX, time-averaged maximum velocity; PSV, peak systolic velocity

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  Fig. 3. Correlations between API and gestational age, pre-pregnancy BMI, PP and mean UtA PI based on restricted cubic spline functions. A API decreased with increasing gestational age. Particularly rapid API declines were noted at 20.4 to 31.1 weeks. B There was a significant inverted U-shaped correlation between API and pre-pregnancy BMI, with the peak API observed at a pre-pregnancy BMI of 29.6 kg/m2. C API increased with PP, notably accelerating at a PP of 44.7 mmHg. D API increased with mean UtA PI, notably accelerating at a mean UtA PI of 1.04 units. API, arterial pressure volume index

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  Fig. 4. Distribution of mean API or AVI by dichotomous variables, using t-tests. Box-and-whisker plots illustrate categorical variables’ effects on API (A) or AVI (B), displaying data from minimum (lowest point/line) to maximum (highest point/line) values. Statistical markers include: first quartile (box bottom), median (internal line), and third quartile (box top)

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  Fig. 5. Cumulative hazard plot showing the association between API and early-onset FGR. * The gestational age is the time when the first fetal ultrasound examination confirmed FGR during the follow-up period

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  Fig. 6. Receiver operating characteristics (ROC) curve of API in identification of early-onset FGR (A) and late-onset FGR (B). AUC: area under the curve. AUC 95% confidence intervals shown in parentheses

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  Fig. 7. Repeatability test of AVI and API by Bland-Altman plot and linear correlation analysis. Bland-Altman analysis (A, C) showed a consistent trend and linear regression analysis (B, D) showed good agreement for AVI inter-observer and intra-observer respectively. Bland-Altman analysis (E, F) showed a consistent trend and linear regression analysis (F, H) showed good agreement for API inter-observer and intra-observer respectively