EARLY UTERINE ARTERY DOPPLER VELOCIMETRY AND THE OUTCOME OF PREGNANCYIN WOMEN AGED 35 YEARS AND OLDER

The objective of this paper was to determine whether first- and second -trimester uterine artery Doppler velocimetry are associated with preg nancy complications in women of advanced maternal age. A prospective c ohort study of 352 women aged 35 years and older was studied. The puls atility index (PI) values at 12-13 weeks of gestation were significant ly associated with development of hypertensive disorders, a small-for- gestational-age infant and gestational diabetes, with a relative risk exceeding 4, 2 and 8, respectively for women with PI values in the hig hest quartile (> 1.67) of the PI distribution when compared with the l owest quartile of the PI distribution (< 1.24). At 23-27 weeks' gestat ion, uterine artery, PI values were found to be associated with preter m delivery with a gestational age-adjusted risk of 10.6 for women with PI values in the highest quartile of PI (> 1.24) when compared with P I values in the lowest quartile of the PI distribution (< 1.09). No as sociations existed between uterine artery PI, antepartum hemorrhage an d Cesarean section rare. The risk estimates for any of the outcome par ameters were not affected by maternal age. Results indicate that hemod ynamic changes detectable in the uterine artery as early as the first trimester of pregnancy are associated with an increased risk of hypert ensive disorders, a small-for-gestational-age infant and gestational d iabetes. A similar association exists in the late second trimester of pregnancy, with an increased risk of preterm delivery.