Leah Paranavitana1, Melissa Walker2,3, Anjana Ravi Chandran2, Natasha Milligan4, Shiri Shinar2, Clare L Whitehead5, Sebastian R Hobson2, Lena Serghides6,7,8, W Tony Parks9,10, Ahmet A Baschat11, Christopher K Macgowan12,13, John G Sled3,12,13,14, John C Kingdom2,3, Lindsay S Cahill15. 1. Department of Chemistry, Memorial University of Newfoundland, 283 Prince Philip Drive, St John's, Newfoundland and Labrador, A1B 3X7, Canada. 2. Mount Sinai Hospital, Toronto, Ontario, Canada. 3. Department of Obstetrics and Gynecology, University of Toronto, Toronto, Ontario, Canada. 4. Division of Cardiology, Department of Paediatrics, The Hospital for Sick Children, Toronto, Ontario, Canada. 5. Pregnancy Research Centre, Department of Obstetrics and Gynaecology, Royal Women's Hospital, Parkville, Australia. 6. Toronto General Hospital Research Institute, University Health Network, Toronto, Ontario, Canada. 7. Department of Immunology and Institute of Medical Sciences, University of Toronto, Toronto, Ontario, Canada. 8. Women's College Research Institute, Women's College Hospital, Toronto, Ontario, Canada. 9. Department of Pathology, Mount Sinai Hospital, Toronto, Ontario, Canada. 10. Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Ontario, Canada. 11. Centre for Fetal Therapy, Johns Hopkins Medicine, Baltimore, Maryland, USA. 12. Translational Medicine, The Hospital for Sick Children, Toronto, Ontario, Canada. 13. Department of Medical Biophysics, University of Toronto, Toronto, Ontario, Canada. 14. Mouse Imaging Centre, The Hospital for Sick Children, Toronto, Ontario, Canada. 15. Department of Chemistry, Memorial University of Newfoundland, 283 Prince Philip Drive, St John's, Newfoundland and Labrador, A1B 3X7, Canada. lcahill@mun.ca.
Abstract
BACKGROUND: There is growing evidence of sex differences in placental vascular development. The objective of this study was to investigate the effect of fetal sex on uterine artery pulsatility index (PI) throughout gestation in a cohort of normal and complicated pregnancies. METHODS: A prospective longitudinal study was conducted in 240 pregnant women. Pulsed wave Doppler ultrasound of the proximal uterine arteries was performed at a 4-weekly interval between 14 and 40 weeks of gestation. The patients were classified retrospectively as normal or complicated (one or more of maternal preeclampsia, preterm birth, or small for gestational age). To assess if the change in uterine artery PI during gestation differed between normal and complicated pregnancies and between fetal sexes, the uterine artery PI was modeled using a linear function of gestational age and the rate of change was estimated from the slope. RESULTS: While the uterine artery PI did not differ over gestation between females and males for normal pregnancies, the trajectory of this index differed by fetal sex for pregnancies complicated by either preeclampsia, preterm birth, or fetal growth restriction (p < 0.0001). The male fetuses in the complicated pregnancy group had an elevated slope compared to the other groups (p < 0.0001), suggesting a more progressive deterioration in uteroplacental perfusion over gestation. CONCLUSIONS: The uterine artery PI is widely used to assess uteroplacental function in clinical settings. The observation that this metric changes more rapidly in complicated pregnancies where the fetus was male highlights the importance of sex when interpreting hemodynamic markers of placental maturation.
BACKGROUND: There is growing evidence of sex differences in placental vascular development. The objective of this study was to investigate the effect of fetal sex on uterine artery pulsatility index (PI) throughout gestation in a cohort of normal and complicated pregnancies. METHODS: A prospective longitudinal study was conducted in 240 pregnant women. Pulsed wave Doppler ultrasound of the proximal uterine arteries was performed at a 4-weekly interval between 14 and 40 weeks of gestation. The patients were classified retrospectively as normal or complicated (one or more of maternal preeclampsia, preterm birth, or small for gestational age). To assess if the change in uterine artery PI during gestation differed between normal and complicated pregnancies and between fetal sexes, the uterine artery PI was modeled using a linear function of gestational age and the rate of change was estimated from the slope. RESULTS: While the uterine artery PI did not differ over gestation between females and males for normal pregnancies, the trajectory of this index differed by fetal sex for pregnancies complicated by either preeclampsia, preterm birth, or fetal growth restriction (p < 0.0001). The male fetuses in the complicated pregnancy group had an elevated slope compared to the other groups (p < 0.0001), suggesting a more progressive deterioration in uteroplacental perfusion over gestation. CONCLUSIONS: The uterine artery PI is widely used to assess uteroplacental function in clinical settings. The observation that this metric changes more rapidly in complicated pregnancies where the fetus was male highlights the importance of sex when interpreting hemodynamic markers of placental maturation.
Authors: Z A Brown; S Schalekamp-Timmermans; H W Tiemeier; A Hofman; V W V Jaddoe; E A P Steegers Journal: Placenta Date: 2014-03-29 Impact factor: 3.481
Authors: Ashley S Meakin; James S M Cuffe; Jack R T Darby; Janna L Morrison; Vicki L Clifton Journal: Int J Mol Sci Date: 2021-06-15 Impact factor: 5.923
Authors: Dakshita Jagota; Hannah George; Melissa Walker; Anjana Ravi Chandran; Natasha Milligan; Shiri Shinar; Clare L Whitehead; Sebastian R Hobson; Lena Serghides; W Tony Parks; Ahmet A Baschat; Christopher K Macgowan; John G Sled; John C Kingdom; Lindsay S Cahill Journal: Biol Sex Differ Date: 2021-03-10 Impact factor: 5.027