Work

Adverse pregnancy outcomes are associated with cardiovascular and renal dysregulation in late pregnancy

Year: 2026

Type: article

Abstract: BACKGROUND: Emerging evidence links adverse pregnancy outcomes (APOs), including gestational diabetes, pregnancy-induced hypertension (PIH), preterm birth, fetal growth restriction and placental abruption to heightened long-term cardiovascular and renal (CVR) disease risks. CVR dysregulation in late pregnancy may be associated with APOs, but the relationship remains understudied. OBJECTIVES: This study investigated CVR biomarkers alterations in women with APOs, assessed cardiorenal interactions, explored dose-response relationships with APO number, and evaluated independent risk factors. STUDY DESIGN: A case-control study was conducted on 340 singleton pregnancies (170 uncomplicated controls, 170 APO cases) at a tertiary maternity hospital in Shanghai. Cardiac hemodynamic markers, including cardiac index (CI) and systemic vascular resistance index (SVRI), were assessed with the USCOM-1 A monitor. Serum levels of cardiac biomarkers (B-type natriuretic peptide [BNP], myoglobin [MYO], creatine kinase isoenzymes [CKMB]) and renal biomarkers (uric acid [UA], blood urea nitrogen [BUN], creatinine [Cr]) were measured, with estimated glomerular filtration rate (eGFR) calculated using the CKD-EPI equation. Correlation analysis and logistic regression were used; sensitivity analyses excluded PIH and placental abruption. RESULTS: Compared to controls, APO cases had significantly lower CI, higher SVRI, and elevated BNP, MYO, UA, and BUN (all p < 0.05). Positive linear trends were observed for SVRI, MYO, UA, BUN, and Cr, while negative trends occurred for CI and eGFR, demonstrating a dose-response relationship with increasing APO number. Significant correlations existed between renal (eGFR, Cr) and cardiovascular markers (CI, SVRI), with stronger associations in multiple-APO cases. A positive correlation between eGFR and BNP was observed only in women with two or more APOs (r = 0.283, p = 0.016). Independent risk factors included UA (aOR 4.46, 95%CI 1.39–14.35, p = 0.012), SVRI (aOR 3.58, 95%CI 1.13–11.36, p = 0.03), MYO (aOR 2.50, 95%CI 1.01–6.18, p = 0.046), and pre-pregnancy BMI (aOR 1.08, 95%CI 1.02–1.15, p = 0.007). Sensitivity analysis excluding PIH attenuated most CVR associations, indicating PIH primarily drove the findings. CONCLUSION: Our findings support the value of monitoring CVR biomarkers in late pregnancy to identify women with established or evolving for APOs and suggest potential targets for intervention to mitigate long-term CVR risks. Future longitudinal studies are required to evaluate early-pregnancy predictive potential across APO subtypes.

Source: BMC Pregnancy and Childbirth

DOI: 10.1186/s12884-026-09022-3

Authors: Weilin Wang, Xiujuan Su, Xinjuan Zhang, Qun Shu, Tao Duan

Institutions: Tongji University, Shanghai First Maternity and Infant Hospital, Shanghai East Hospital

Language: English

Topic: Pregnancy and preeclampsia studies

Subfield: Obstetrics and Gynecology

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $3,290