OBJECTIVE: To examine the relationship between smallness at birth and the predictive value of umbilical artery Doppler. DESIGN: Retrospective cohort. SETTING: Tertiary referral university hospital, Barcelona. POPULATION: A total of 7645 singleton pregnancies delivered between January 2002 and June 2004. METHODS: The associations with adverse outcome were assessed for small-for-gestational-age (SGA) babies according to customised standards who had normal and abnormal umbilical artery Doppler. MAIN OUTCOME MEASURES: Neonatal morbidity and perinatal mortality. RESULTS: Of the 369 SGA fetuses that had been identified antenatally, 70 (19%) had an abnormal umbilical artery Doppler and the babies from these pregnancies had a higher risk for neonatal morbidity when compared with babies with normal birthweight (OR 3.99, 95% CI 1.04-11.03). However, the remaining 299 (81%) fetuses with normal umbilical artery Doppler also had an elevated risk of neonatal morbidity (OR 2.26, 95% CI 1.04-4.39). Overall, many of the instances of adverse outcome associated with smallness for gestational age were attributable to the group with normal Doppler than to the group with abnormal Doppler. CONCLUSION: Normal antenatal umbilical artery Doppler cannot be taken as an indicator of low risk in pregnancies where the fetus is SGA according to customised percentiles.
OBJECTIVE: To examine the relationship between smallness at birth and the predictive value of umbilical artery Doppler. DESIGN: Retrospective cohort. SETTING: Tertiary referral university hospital, Barcelona. POPULATION: A total of 7645 singleton pregnancies delivered between January 2002 and June 2004. METHODS: The associations with adverse outcome were assessed for small-for-gestational-age (SGA) babies according to customised standards who had normal and abnormal umbilical artery Doppler. MAIN OUTCOME MEASURES: Neonatal morbidity and perinatal mortality. RESULTS: Of the 369 SGA fetuses that had been identified antenatally, 70 (19%) had an abnormal umbilical artery Doppler and the babies from these pregnancies had a higher risk for neonatal morbidity when compared with babies with normal birthweight (OR 3.99, 95% CI 1.04-11.03). However, the remaining 299 (81%) fetuses with normal umbilical artery Doppler also had an elevated risk of neonatal morbidity (OR 2.26, 95% CI 1.04-4.39). Overall, many of the instances of adverse outcome associated with smallness for gestational age were attributable to the group with normal Doppler than to the group with abnormal Doppler. CONCLUSION: Normal antenatal umbilical artery Doppler cannot be taken as an indicator of low risk in pregnancies where the fetus is SGA according to customised percentiles.
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