TY - JOUR
T1 - A Low Cerebroplacental Ratio at 20-24 Weeks of Gestation Can Predict Reduced Fetal Size Later in Pregnancy or at Birth
AU - Hernandez-Andrade, Edgar
AU - Maymon, Eli
AU - Erez, Offer
AU - Saker, Homam
AU - Luewan, Suchaya
AU - Garcia, Maynor
AU - Ahn, Hyunyoung
AU - Tarca, Adi L.
AU - Done, Bogdan
AU - Korzeniewski, Steven J.
AU - Hassan, Sonia S.
AU - Romero, Roberto
N1 - Funding Information:
This research was supported, in part, by the Perinatology Research Branch, Division of Obstetrics and Maternal-Fetal Medicine, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, U.S. Department of Health and Human Services (NICHD/NIH/DHHS) and, in part, with Federal funds from NICHD/NIH/DHHS under Contract No. HH-SN275201300006C. The ultrasound experience and technical support of senior registered diagnostic medical sonographers Catherine Ducharme and Denise Haggerty are gratefully acknowledged.
Funding Information:
This cohort study was conducted at the Center for Advanced Obstetrical Care and Research (CAOCR), Perinatology Research Branch of the Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, U.S. Department of Health and Human Services (NICHD/NIH/ DHHS), Wayne State University School of Medicine, and Hutzel Women’s Hospital, Detroit, MI, USA. All patients provided written informed consent for ultrasound examinations and were enrolled in research protocols approved by the Human Investigation Committee of Wayne State University and by the Institutional Review Board of NICHD.
Publisher Copyright:
© 2017 © 2017 S. Karger AG, Basel. Copyright: All rights reserved.
PY - 2018/8/1
Y1 - 2018/8/1
N2 - Aim: To determine whether Doppler evaluation at 20-24 weeks of gestation can predict reduced fetal size later in pregnancy or at birth. Methods: Fetal biometry and Doppler velocimetry were performed in 2,986 women with a singleton pregnancy at 20-24 weeks of gestation. Predictive performances of the umbilical artery pulsatility index (UA-PI) or the mean uterine artery pulsatility index (UtA-PI) >95th percentile, middle cerebral artery pulsatility index, or cerebroplacental ratio (CPR) <5th percentile for early small for gestational age (SGA; <34 weeks of gestation), late SGA (≥34 weeks of gestation), or SGA at birth (birthweight <10th percentile) were analyzed. Results: The prevalence of early SGA, late SGA, and SGA at birth was 1.1, 9.6, and 14.7%, respectively. A CPR <5th percentile had a positive likelihood ratio (LR+) of 8.2 (95% confidence interval [CI] 5.7-12.0) for early SGA, a LR+ of 1.6 (95% CI 1.1-1.2) for late SGA, and a LR+ of 1.9 (95% CI 1.4-2.6) for SGA at birth. A UtA-PI >95th percentile was associated with late SGA and SGA at birth, while an UA-PI >95th percentile was associated with early SGA. Associations were higher in fetuses with an estimated fetal weight <10th percentile. Conclusion: Fetal biometry and Doppler evaluation at 20-24 weeks of gestation can predict early and late SGA as well as SGA at birth.
AB - Aim: To determine whether Doppler evaluation at 20-24 weeks of gestation can predict reduced fetal size later in pregnancy or at birth. Methods: Fetal biometry and Doppler velocimetry were performed in 2,986 women with a singleton pregnancy at 20-24 weeks of gestation. Predictive performances of the umbilical artery pulsatility index (UA-PI) or the mean uterine artery pulsatility index (UtA-PI) >95th percentile, middle cerebral artery pulsatility index, or cerebroplacental ratio (CPR) <5th percentile for early small for gestational age (SGA; <34 weeks of gestation), late SGA (≥34 weeks of gestation), or SGA at birth (birthweight <10th percentile) were analyzed. Results: The prevalence of early SGA, late SGA, and SGA at birth was 1.1, 9.6, and 14.7%, respectively. A CPR <5th percentile had a positive likelihood ratio (LR+) of 8.2 (95% confidence interval [CI] 5.7-12.0) for early SGA, a LR+ of 1.6 (95% CI 1.1-1.2) for late SGA, and a LR+ of 1.9 (95% CI 1.4-2.6) for SGA at birth. A UtA-PI >95th percentile was associated with late SGA and SGA at birth, while an UA-PI >95th percentile was associated with early SGA. Associations were higher in fetuses with an estimated fetal weight <10th percentile. Conclusion: Fetal biometry and Doppler evaluation at 20-24 weeks of gestation can predict early and late SGA as well as SGA at birth.
UR - http://www.scopus.com/inward/record.url?scp=85029745911&partnerID=8YFLogxK
U2 - 10.1159/000479684
DO - 10.1159/000479684
M3 - Article
AN - SCOPUS:85029745911
SN - 1015-3837
VL - 44
SP - 112
EP - 123
JO - Fetal Diagnosis and Therapy
JF - Fetal Diagnosis and Therapy
IS - 2
ER -