ARTERIAL STIFFNESS IN PREECLAMPSIA AND GESTATIONAL DIABETES: A CASE-CONTROL STUDY

Objective: Preeclampsia (PE) and gestational diabetes (GDM) are major causes of maternal and fetal morbidity and mortality. Vascular dysfunction is central to their pathogenesis, often marked by changes in arterial stiffness. However, little is understood about the role of arterial stiffness as a predictive marker for the development of complications during pregnancy. In this study, we aimed to assess the association between central and peripheral arterial stiffness and the onset of hypertensive disorders in pregnancy (HDP) and/or GDM.Design and method: We enrolled 135 pregnant women who had their first prenatal visit at the University of Bologna’s obstetric clinic. Arterial applanation tonometry (PulsePen) was performed at 11+0-15 +6 weeks and 24+0-28+6 weeks of gestation. The composite outcome considered was the development of HDP and/or GDM. Of the 135 participants, 33 developed at least one of the conditions, while 102 had uncomplicated pregnancies. Results: Our results revealed that women who developed HDP or GDM exhibited increased central and peripheral arterial stiffness indices in both the first and second trimesters. In particular, a difference of approximately 0.6 m/s was observed for carotid-femoral Pulse wave velocity (cf-PWV) (1st trimester, 7.55 ± 1.47 vs 6.93 ± 0.71, p value 0.025; 2nd trimester 6.78 ± 1.09 vs 6.11 ± 0.65 p value 0.002) and for carotid-radial PWV (cr-PWV) (1st trimester, 8.33 ± 1.26 vs 7.67 ± 1.09, p value 0.004; 2nd trimester 8.05 ± 1.47 vs 7.47 ± 1.23 p value 0.031) between complicated pregnancies and healthy controls. These indices were significantly correlated with the severity of the pathological phenotype. Regression models, adjusted for age and BMI, showed that cf-PWV from both trimesters could predict the onset of at least one of the conditions (1st trimester OR 1.79 p value 0.02; 2nd trimester OR 2.57 p value 0.002). Conclusions: In conclusion, increased arterial stiffness appears to precede the development of HDP or GDM, highlighting its potential as an early predictive marker. Despite promising findings, the mechanisms underlying these changes in pregnancy remain poorly understood and warrant further investigation.