F Figueras1, S Savchev, S Triunfo, F Crovetto, E Gratacos. 1. Fetal and Perinatal Research Centre, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain; BCNatal, Barcelona Center for Maternal, Fetal and Neonatal Medicine, Hospital Clínic and Hospital Sant Joan de Déu, University of Barcelona, Barcelona, Spain; University of Barcelona, Barcelona, Spain.
Abstract
OBJECTIVE: To develop an integrated model with the best performing criteria for predicting adverse outcome in small-for-gestational-age (SGA) pregnancies. METHODS: A cohort of 509 pregnancies with a suspected SGA fetus, eligible for trial of labor, was recruited prospectively and data on perinatal outcome were recorded. A predictive model for emergency Cesarean delivery because of non-reassuring fetal status or neonatal acidosis was constructed using a decision tree analysis algorithm, with predictors: maternal age, body mass index, smoking, nulliparity, gestational age at delivery, onset of labor (induced vs spontaneous), estimated fetal weight (EFW), umbilical artery pulsatility index (PI), mean uterine artery (UtA) PI, fetal middle cerebral artery PI and cerebroplacental ratio (CPR). RESULTS: An adverse outcome occurred in 134 (26.3%) cases. The best performing predictors for defining a high risk for adverse outcome in SGA fetuses was the presence of a CPR < 10th centile, a mean UtA-PI > 95th centile or an EFW < 3rd centile. The algorithm showed a sensitivity, specificity and positive and negative predictive values for adverse outcome of 82.8% (95% CI, 75.1-88.6%), 47.7% (95% CI, 42.6-52.9%), 36.2% (95% CI, 30.8-41.8%) and 88.6% (95% CI, 83.2-92.5%), respectively. Positive and negative likelihood ratios were 1.58 and 0.36. CONCLUSIONS: Our model could be used as a diagnostic tool for discriminating SGA pregnancies at risk of adverse perinatal outcome.
OBJECTIVE: To develop an integrated model with the best performing criteria for predicting adverse outcome in small-for-gestational-age (SGA) pregnancies. METHODS: A cohort of 509 pregnancies with a suspected SGA fetus, eligible for trial of labor, was recruited prospectively and data on perinatal outcome were recorded. A predictive model for emergency Cesarean delivery because of non-reassuring fetal status or neonatal acidosis was constructed using a decision tree analysis algorithm, with predictors: maternal age, body mass index, smoking, nulliparity, gestational age at delivery, onset of labor (induced vs spontaneous), estimated fetal weight (EFW), umbilical artery pulsatility index (PI), mean uterine artery (UtA) PI, fetal middle cerebral artery PI and cerebroplacental ratio (CPR). RESULTS: An adverse outcome occurred in 134 (26.3%) cases. The best performing predictors for defining a high risk for adverse outcome in SGA fetuses was the presence of a CPR < 10th centile, a mean UtA-PI > 95th centile or an EFW < 3rd centile. The algorithm showed a sensitivity, specificity and positive and negative predictive values for adverse outcome of 82.8% (95% CI, 75.1-88.6%), 47.7% (95% CI, 42.6-52.9%), 36.2% (95% CI, 30.8-41.8%) and 88.6% (95% CI, 83.2-92.5%), respectively. Positive and negative likelihood ratios were 1.58 and 0.36. CONCLUSIONS: Our model could be used as a diagnostic tool for discriminating SGA pregnancies at risk of adverse perinatal outcome.
Authors: Manouk L E Hendrix; Judith A P Bons; Roy R G Snellings; Otto Bekers; Sander M J van Kuijk; Marc E A Spaanderman; Salwan Al-Nasiry Journal: Fetal Diagn Ther Date: 2019-05-08 Impact factor: 2.587
Authors: Nir Melamed; Ahmet Baschat; Yoav Yinon; Apostolos Athanasiadis; Federico Mecacci; Francesc Figueras; Vincenzo Berghella; Amala Nazareth; Muna Tahlak; H David McIntyre; Fabrício Da Silva Costa; Anne B Kihara; Eran Hadar; Fionnuala McAuliffe; Mark Hanson; Ronald C Ma; Rachel Gooden; Eyal Sheiner; Anil Kapur; Hema Divakar; Diogo Ayres-de-Campos; Liran Hiersch; Liona C Poon; John Kingdom; Roberto Romero; Moshe Hod Journal: Int J Gynaecol Obstet Date: 2021-03 Impact factor: 3.561
Authors: Eileen I Chang; Paul J Rozance; Stephanie R Wesolowski; Leanna M Nguyen; Steven C Shaw; Robert A Sclafani; Kristen K Bjorkman; Angela K Peter; William Hay; Laura D Brown Journal: J Endocrinol Date: 2019-12-19 Impact factor: 4.286
Authors: Andrea Dall'Asta; Valentina Brunelli; Federico Prefumo; Tiziana Frusca; Christoph C Lees Journal: Matern Health Neonatol Perinatol Date: 2017-01-18
Authors: Paul J Rozance; Stephanie R Wesolowski; Sonnet S Jonker; Laura D Brown Journal: Am J Physiol Regul Integr Comp Physiol Date: 2021-07-21 Impact factor: 3.210
Authors: Teresa M MacDonald; Lisa Hui; Stephen Tong; Alice J Robinson; Kirsten M Dane; Anna L Middleton; Susan P Walker Journal: BMC Med Date: 2017-08-31 Impact factor: 8.775
Authors: L Andreoli; G K Bertsias; N Agmon-Levin; S Brown; R Cervera; N Costedoat-Chalumeau; A Doria; R Fischer-Betz; F Forger; M F Moraes-Fontes; M Khamashta; J King; A Lojacono; F Marchiori; P L Meroni; M Mosca; M Motta; M Ostensen; C Pamfil; L Raio; M Schneider; E Svenungsson; M Tektonidou; S Yavuz; D Boumpas; A Tincani Journal: Ann Rheum Dis Date: 2016-07-25 Impact factor: 19.103
Authors: Jezid Miranda; Rui V Simões; Cristina Paules; Daniel Cañueto; Miguel A Pardo-Cea; María L García-Martín; Francesca Crovetto; Rocio Fuertes-Martin; Monica Domenech; María D Gómez-Roig; Elisenda Eixarch; Ramon Estruch; Stefan R Hansson; Nuria Amigó; Nicolau Cañellas; Fatima Crispi; Eduard Gratacós Journal: Sci Rep Date: 2018-09-11 Impact factor: 4.379