LAUSR

P lacental-mediated pregnancy complications, such as preeclampsia, fetal growth restriction, and placental abruption, are somewhat unique to the human species [1] and affect 2–8% of pregnancies worldwide [2–5]. Although the risk factors for these complications are well established [5–7], current clinical screening tests are not predictive in nature and only serve to identify at risk individuals for further diagnostic testing or monitoring [8,9]. Given the large impact placental-mediated diseases have on maternal and fetal morbidity and mortality [10], there is a need for predictive tests that can be easily performed in the early stages of pregnancy to facilitate early interventions for management and potentially prevention of these complications. Such predictive tests should be simple, noninvasive, and cost-effective to ensure ease of clinical adoption. Normal pregnancy is associated with an array of cardiovascular adaptations that are necessary for coping with the increased blood flow demand to the placenta [11], and disruptions to placental blood flow is often associated with compromised pregnancies [12]. Furthermore, it has been shown that increased arterial stiffness and wave reflection are associated with placental-mediated diseases, such as preeclampsia [13]. Given the ease of noninvasive assessment of arterial stiffness and wave reflection by way of pulse wave velocity (PWV) measurement and arterial pulse wave analysis (PWA), there has been increasing research into the potential predictive value of arterial stiffness and wave reflection indices in pregnancy for the development of placental-mediated diseases [14–16]. In this issue of the Journal of Hypertension, Osman et al. [17] present a first systematic review and meta-analysis of published