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Article

The Cerebroplacental–Renal Ratio as a Novel Doppler-Based Marker of Adverse Perinatal Outcome in Pregnancy-Induced Hypertension

by
Yücel Kaya
1,*,
Kübra Kurt Bilirer
1,
Aybekcan Batman
1,
Burcu Çiçek
1,
İlteriş Yaman
2,
Ali Selçuk Yeniocak
3,
Can Tercan
3,
Karolin Ohanoglu Cetinel
3,
Damla Yasemin Yenliç Kaya
4 and
Gülseren Polat
5
1
Division of Perinatology, Department of Obstetrics and Gynecology, Basaksehir Cam and Sakura City Hospital, Istanbul 34480, Turkey
2
Division of Gynecologic Oncology Surgery, Department of Obstetrics and Gynecology, Basaksehir Cam and Sakura City Hospital, Istanbul 34480, Turkey
3
Department of Obstetrics and Gynecology, Basaksehir Cam and Sakura City Hospital, Istanbul 34480, Turkey
4
Department of Obstetrics and Gynecology, Medipol University Esenler Hospital, Istanbul 34250, Turkey
5
Department of Vocational Health Services, Istanbul Gelisim University, Istanbul 34310, Turkey
*
Author to whom correspondence should be addressed.
Medicina 2026, 62(9), 1806; https://doi.org/10.3390/medicina62091806 (registering DOI)
Submission received: 15 July 2026 / Revised: 10 September 2026 / Accepted: 16 September 2026 / Published: 19 September 2026
(This article belongs to the Section Obstetrics and Gynecology)
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Abstract

Background/Objectives: To evaluate the association between the newly defined cerebroplacental–renal ratio (CPRR) and adverse perinatal outcome (APO) in pregnancy-induced hypertension (PIH), and to compare its discriminative performance with the cerebroplacental ratio (CPR) and cerebroplacental–uterine ratio (CPUR). Methods: This prospective, single-center cohort study included 105 women with PIH (preeclampsia, n = 63; gestational hypertension, n = 42). Doppler assessment was performed at ≥34 + 0 weeks and within 7 days before delivery. CPR was calculated as middle cerebral artery pulsatility index (PI)/umbilical artery PI, CPUR as CPR/mean uterine artery PI, and CPRR as CPR/right renal artery PI. APO was defined by the presence of any of the following: non-reassuring fetal status, a 5 min Apgar score <7, neonatal intensive care unit admission, or neonatal death. Receiver operating characteristic analysis and multivariable logistic regression adjusted for gestational age at ultrasound assessment and diagnosis group were performed. Results: APO occurred in 37 pregnancies (35.2%). CPUR and CPRR were significantly lower in the APO group, whereas CPR did not differ significantly. CPRR showed a higher apparent AUC for APO than CPR and CPUR (AUC 0.786, 95% CI 0.698–0.875), with significantly higher AUCs on pairwise DeLong comparisons. After adjustment, CPRR was the only Doppler index independently associated with APO (adjusted OR 1.423 per 0.1-unit decrease; 95% CI 1.162–1.743; p = 0.001). Conclusions: CPRR was independently associated with APO in PIH and showed higher discriminative performance than CPR and CPUR; however, these findings require validation in independent, multicenter studies before clinical application.
Keywords: pre-eclampsia; ultrasonography; renal artery; pregnancy outcome; pregnancy complications pre-eclampsia; ultrasonography; renal artery; pregnancy outcome; pregnancy complications

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MDPI and ACS Style

Kaya, Y.; Bilirer, K.K.; Batman, A.; Çiçek, B.; Yaman, İ.; Yeniocak, A.S.; Tercan, C.; Ohanoglu Cetinel, K.; Kaya, D.Y.Y.; Polat, G. The Cerebroplacental–Renal Ratio as a Novel Doppler-Based Marker of Adverse Perinatal Outcome in Pregnancy-Induced Hypertension. Medicina 2026, 62, 1806. https://doi.org/10.3390/medicina62091806

AMA Style

Kaya Y, Bilirer KK, Batman A, Çiçek B, Yaman İ, Yeniocak AS, Tercan C, Ohanoglu Cetinel K, Kaya DYY, Polat G. The Cerebroplacental–Renal Ratio as a Novel Doppler-Based Marker of Adverse Perinatal Outcome in Pregnancy-Induced Hypertension. Medicina. 2026; 62(9):1806. https://doi.org/10.3390/medicina62091806

Chicago/Turabian Style

Kaya, Yücel, Kübra Kurt Bilirer, Aybekcan Batman, Burcu Çiçek, İlteriş Yaman, Ali Selçuk Yeniocak, Can Tercan, Karolin Ohanoglu Cetinel, Damla Yasemin Yenliç Kaya, and Gülseren Polat. 2026. "The Cerebroplacental–Renal Ratio as a Novel Doppler-Based Marker of Adverse Perinatal Outcome in Pregnancy-Induced Hypertension" Medicina 62, no. 9: 1806. https://doi.org/10.3390/medicina62091806

APA Style

Kaya, Y., Bilirer, K. K., Batman, A., Çiçek, B., Yaman, İ., Yeniocak, A. S., Tercan, C., Ohanoglu Cetinel, K., Kaya, D. Y. Y., & Polat, G. (2026). The Cerebroplacental–Renal Ratio as a Novel Doppler-Based Marker of Adverse Perinatal Outcome in Pregnancy-Induced Hypertension. Medicina, 62(9), 1806. https://doi.org/10.3390/medicina62091806

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