Arterial stiffness and placental growth factor in pregnancy

Decoding Pregnancy Risks: How Arterial Stiffness and Placental Growth Factor Impact Outcomes

Beau Callahan in Health & Wellness June 2025 • 4 min read.

"New research sheds light on predicting adverse pregnancy outcomes in women with chronic hypertension by assessing arterial stiffness and placental growth factor."

Chronic hypertension during pregnancy presents significant risks, often leading to adverse outcomes such as preeclampsia, fetal growth restriction, and preterm birth. Identifying women at high risk early in pregnancy is crucial for timely interventions that can improve both maternal and fetal health. Recent research has focused on identifying biomarkers that can predict these complications before they arise.

A study presented at the American Journal of Obstetrics & Gynecology explored the potential of arterial stiffness, measured by pulse wave velocity (PWV), and placental growth factor (PlGF) as independent predictors of adverse pregnancy outcomes in women with chronic hypertension. The study aimed to determine whether these factors could help identify women who would develop early placental disease, requiring delivery before 34 weeks of gestation.

By understanding how these biomarkers correlate with pregnancy outcomes, healthcare providers can better stratify risk, implement targeted interventions, and ultimately improve the health trajectories for both mother and child. This article delves into the findings of this study, offering insights into the implications for prenatal care and future research.

Arterial Stiffness and Placental Growth Factor: Key Predictors?

Arterial stiffness and placental growth factor in pregnancy

The prospective cohort study included 503 women with a diagnosis of hypertension before pregnancy or before 20 weeks of gestation, and/or a history of preeclampsia before 34 weeks, in a previous pregnancy. Researchers measured pulse wave velocity (PWV), an indicator of arterial stiffness, and placental growth factor (PlGF) longitudinally. The primary outcome was placental disease requiring delivery before 34 weeks of gestation due to preeclampsia, with or without fetal growth restriction (FGR). All participants were prescribed aspirin as a preventive measure.

The results indicated that women who developed early placental disease exhibited significantly elevated PWV and lower PlGF levels throughout their pregnancy. Specifically, in multiparous women with a history of complicated pregnancies, early pregnancy PWV was not as markedly elevated as in first-time mothers who also developed early placental disease. However, the PlGF value was consistently lower in the multiparous group. These findings suggest that both arterial stiffness and placental function play critical roles in the development of early placental disease.

Elevated Pulse Wave Velocity (PWV): Higher PWV values indicate stiffer arteries, which can impair blood flow to the placenta.
Reduced Placental Growth Factor (PlGF): Lower PlGF levels suggest compromised placental development and function.
Impact of Prior Complications: Previous complicated pregnancies can modify these biomarker patterns.
Early Prediction: Measuring PWV and PlGF early in pregnancy can provide insights into potential complications.

Multivariable logistic regression, combining PWV and PlGF measurements in early pregnancy, demonstrated a modest sensitivity (77%) for predicting early placental disease, with a positive predictive value of 24%. While not definitive, these measurements offer valuable information for risk stratification.

Implications for Future Pregnancy Care

The study underscores the importance of assessing arterial stiffness and placental growth factor in hypertensive women during early pregnancy. These measurements can help identify women at higher risk of developing early placental disease, allowing for more intensive monitoring and potential interventions. While the sensitivity and positive predictive value are not perfect, incorporating these biomarkers into clinical practice can refine risk stratification and improve outcomes.

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Everything You Need To Know

What does arterial stiffness, indicated by pulse wave velocity (PWV), tell us about pregnancy risks?

Arterial stiffness, as measured by pulse wave velocity (PWV), refers to the rigidity of the arteries. Elevated PWV indicates that the arteries are less flexible, which can impede efficient blood flow. This is significant because, during pregnancy, adequate blood flow to the placenta is vital for fetal development. Increased arterial stiffness can impair this blood flow, potentially leading to complications. The implications of arterial stiffness include a higher risk of placental disease and adverse pregnancy outcomes, particularly in women with chronic hypertension.

What is placental growth factor (PlGF) and why is it important during pregnancy?

Placental growth factor (PlGF) is a protein that promotes the growth of blood vessels in the placenta. Lower levels of PlGF suggest that the placenta may not be developing properly or functioning optimally. This is important because a healthy placenta is essential for providing the fetus with oxygen and nutrients. Reduced PlGF levels are associated with compromised placental development, potentially leading to fetal growth restriction and preeclampsia. Therefore, monitoring PlGF levels can help identify pregnancies at risk of placental-related complications.

Why are pulse wave velocity (PWV) and placental growth factor (PlGF) measurements being used to predict pregnancy complications?

Pulse wave velocity (PWV) and placental growth factor (PlGF) are significant because they can serve as early predictors of adverse pregnancy outcomes in women with chronic hypertension. By measuring these biomarkers early in pregnancy, healthcare providers can identify women at higher risk of developing early placental disease. This early identification allows for more intensive monitoring, targeted interventions, and potentially improved outcomes for both the mother and the child. While not definitive, these measurements can refine risk stratification and enhance prenatal care strategies.

What exactly is considered 'early placental disease' and why is it so important to identify it early?

In the context of predicting pregnancy risks, early placental disease refers to conditions like preeclampsia or fetal growth restriction that necessitate delivery before 34 weeks of gestation. Identifying women at risk of early placental disease is crucial because it allows for timely interventions to mitigate potential complications. Conditions such as preeclampsia, characterized by high blood pressure and organ damage, and fetal growth restriction, where the baby doesn't grow at the expected rate, pose significant risks to both maternal and fetal health. Early prediction and management can improve outcomes.

Why was aspirin prescribed to all the participants in the study, and what role does it play?

Aspirin is prescribed as a preventive measure during pregnancy, particularly for women at high risk of developing preeclampsia. Aspirin works by inhibiting the production of thromboxane, a substance that promotes blood clotting and vasoconstriction. By reducing blood clotting and improving blood flow, aspirin can help prevent placental dysfunction and reduce the risk of preeclampsia. In the study, all participants were prescribed aspirin, highlighting its importance in managing pregnancy risks associated with chronic hypertension and previous complicated pregnancies. However, aspirin alone may not completely eliminate the risk, underscoring the need for additional biomarkers like PWV and PlGF for comprehensive risk assessment.