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Mid-pregnancy fetal biometry, uterine artery Doppler indices and maternal demographic characteristics: role in prediction of small-for-gestational-age birth.
Acta Obstet Gynecol Scand 2016; 95(2):238-44AO

Abstract

INTRODUCTION

The aim of this study was to evaluate the role of mid-trimester fetal biometry, uterine artery Doppler indices and maternal demographics in prediction of small-for-gestational-age (SGA) birth.

MATERIALS AND METHODS

We conducted a retrospective cohort study in a single referral center. The study included 23 894 singleton pregnancies scanned between 19 and 24 weeks of gestation. Maternal demographics included age, body mass index and ethnicity. Fetal biometry, birthweight and uterine artery pulsatility index values were converted into centiles. Multivariable logistic regression analysis was performed and the predictive accuracy was assessed using receiver operating characteristic curve analysis. The main outcome measure was prediction of delivery of preterm and term SGA neonates defined as a birthweight in the lowest centile groups (<10th, <5th and <3rd centiles).

RESULTS

Maternal ethnicity, fetal biometry and uterine artery Doppler indices were significantly associated with the risk of SGA <5th centile (p < 0.01). Maternal factors or fetal biometry alone showed poor to moderate performance in prediction of term and preterm SGA <5th centile at a 10% false-positive rate. Uterine artery pulsatility index alone was able to predict 25, 60 and 77% of SGA <5th centile delivering at >37, <37 and <32 weeks of gestation respectively at a 10% false-positive rate; maternal factors, fetal biometry and uterine artery Doppler combined detected 40, 66 and 89% of term, preterm and very preterm SGA <5th centile at a 10% false-positive rate.

CONCLUSIONS

Second-trimester screening can identify the majority of pregnancies at high risk of SGA birth and showed a higher performance for earlier gestational ages at birth and lower birthweight centiles.

Authors+Show Affiliations

Fetal Medicine Unit, Academic Department of Obstetrics and Gynaecology, St George's University of London, London, UK.Fetal Medicine Unit, Academic Department of Obstetrics and Gynaecology, St George's University of London, London, UK.Fetal Medicine Unit, Academic Department of Obstetrics and Gynaecology, St George's University of London, London, UK.Fetal Medicine Unit, Academic Department of Obstetrics and Gynaecology, St George's University of London, London, UK.Fetal Medicine Unit, Academic Department of Obstetrics and Gynaecology, St George's University of London, London, UK.Fetal Medicine Unit, Academic Department of Obstetrics and Gynaecology, St George's University of London, London, UK.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

26472057

Citation

Familiari, Alessandra, et al. "Mid-pregnancy Fetal Biometry, Uterine Artery Doppler Indices and Maternal Demographic Characteristics: Role in Prediction of Small-for-gestational-age Birth." Acta Obstetricia Et Gynecologica Scandinavica, vol. 95, no. 2, 2016, pp. 238-44.
Familiari A, Bhide A, Morlando M, et al. Mid-pregnancy fetal biometry, uterine artery Doppler indices and maternal demographic characteristics: role in prediction of small-for-gestational-age birth. Acta Obstet Gynecol Scand. 2016;95(2):238-44.
Familiari, A., Bhide, A., Morlando, M., Scala, C., Khalil, A., & Thilaganathan, B. (2016). Mid-pregnancy fetal biometry, uterine artery Doppler indices and maternal demographic characteristics: role in prediction of small-for-gestational-age birth. Acta Obstetricia Et Gynecologica Scandinavica, 95(2), pp. 238-44. doi:10.1111/aogs.12804.
Familiari A, et al. Mid-pregnancy Fetal Biometry, Uterine Artery Doppler Indices and Maternal Demographic Characteristics: Role in Prediction of Small-for-gestational-age Birth. Acta Obstet Gynecol Scand. 2016;95(2):238-44. PubMed PMID: 26472057.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Mid-pregnancy fetal biometry, uterine artery Doppler indices and maternal demographic characteristics: role in prediction of small-for-gestational-age birth. AU - Familiari,Alessandra, AU - Bhide,Amar, AU - Morlando,Maddalena, AU - Scala,Carolina, AU - Khalil,Asma, AU - Thilaganathan,Basky, Y1 - 2015/11/08/ PY - 2015/05/21/received PY - 2015/10/09/accepted PY - 2015/10/17/entrez PY - 2015/10/17/pubmed PY - 2016/5/10/medline KW - Small-for-gestational age KW - fetal biometry KW - maternal demographics KW - prediction of high risk pregnancies KW - second-trimester screening KW - uterine artery Doppler SP - 238 EP - 44 JF - Acta obstetricia et gynecologica Scandinavica JO - Acta Obstet Gynecol Scand VL - 95 IS - 2 N2 - INTRODUCTION: The aim of this study was to evaluate the role of mid-trimester fetal biometry, uterine artery Doppler indices and maternal demographics in prediction of small-for-gestational-age (SGA) birth. MATERIALS AND METHODS: We conducted a retrospective cohort study in a single referral center. The study included 23 894 singleton pregnancies scanned between 19 and 24 weeks of gestation. Maternal demographics included age, body mass index and ethnicity. Fetal biometry, birthweight and uterine artery pulsatility index values were converted into centiles. Multivariable logistic regression analysis was performed and the predictive accuracy was assessed using receiver operating characteristic curve analysis. The main outcome measure was prediction of delivery of preterm and term SGA neonates defined as a birthweight in the lowest centile groups (<10th, <5th and <3rd centiles). RESULTS: Maternal ethnicity, fetal biometry and uterine artery Doppler indices were significantly associated with the risk of SGA <5th centile (p < 0.01). Maternal factors or fetal biometry alone showed poor to moderate performance in prediction of term and preterm SGA <5th centile at a 10% false-positive rate. Uterine artery pulsatility index alone was able to predict 25, 60 and 77% of SGA <5th centile delivering at >37, <37 and <32 weeks of gestation respectively at a 10% false-positive rate; maternal factors, fetal biometry and uterine artery Doppler combined detected 40, 66 and 89% of term, preterm and very preterm SGA <5th centile at a 10% false-positive rate. CONCLUSIONS: Second-trimester screening can identify the majority of pregnancies at high risk of SGA birth and showed a higher performance for earlier gestational ages at birth and lower birthweight centiles. SN - 1600-0412 UR - https://www.unboundmedicine.com/medline/citation/26472057/Mid_pregnancy_fetal_biometry_uterine_artery_Doppler_indices_and_maternal_demographic_characteristics:_role_in_prediction_of_small_for_gestational_age_birth_ L2 - https://doi.org/10.1111/aogs.12804 DB - PRIME DP - Unbound Medicine ER -