Nathan R Blue1, Matthew Hoffman2, Amanda A Allshouse1, William A Grobman3, Hyagriv N Simhan4, Ozhan M Turan5, Samuel Parry6, Judith H Chung7, Uma Reddy8, David M Haas9, Stephen Myers10, Brian Mercer11, George R Saade12, Robert M Silver1. 1. Department of Obstetrics and Gynecology, University of Utah Health, Salt Lake City, Utah. 2. Department of Obstetrics and Gynecology, Christiana Care Health System, Wilmington, Delaware. 3. Department of Obstetrics and Gynecology, Northwestern University, Chicago, Illinois. 4. Department of Obstetrics, Gynecology, and Reproductive Sciences, Magee-Womens Hospital of UPMC, Pittsburgh, Pennsylvania. 5. Department of Obstetrics, Gynecology and Reproductive Sciences, University of Maryland School of Medicine, Baltimore, Maryland. 6. Department of Obstetrics and Gynecology, University of Pennsylvania, Philadelphia, Pennsylvania. 7. Department of Obstetrics and Gynecology, University of California, Irvine, Orange, California. 8. Department of Obstetrics, Gynecology, and Reproductive Sciences, Yale School of Medicine, Yale University, New Haven, Connecticut. 9. Department of Obstetrics and Gynecology, Indiana University School of Medicine, Indianapolis, Indiana. 10. Department of Obstetrics and Gynecology, University of Kansas Medical Center, Kansas City, Kansas. 11. Department of Obstetrics and Gynecology, MetroHealth Medical Center, Cleveland, Ohio. 12. Department of Obstetrics and Gynecology, University of Texas Medical Branch, Galveston, Texas.
Abstract
OBJECTIVE: Our objective was to test the association of fetal adrenal size with perinatal morbidity among fetuses with fetal growth restriction (FGR; estimated fetal weight [EFW] < 10th percentile). STUDY DESIGN: This was a secondary analysis of the Nulliparous Pregnancy Outcomes Study: Monitoring Mothers-to-be (nuMoM2b) adrenal study, which measured fetal adrenal gland size at 22 to 30 weeks' gestation. We analyzed the transverse adrenal area (TAA) and fetal zone area (absolute measurements and corrected for fetal size) and the ratio of the fetal zone area to the total transverse area using a composite perinatal outcome of stillbirth, neonatal intensive care unit admission, respiratory distress syndrome, necrotizing enterocolitis, retinopathy of prematurity, sepsis, mechanical ventilation, seizure, or death. Among fetuses with FGR, adrenal measurements were compared between those that did and did not experience the composite perinatal outcome. RESULTS: There were 1,709 eligible neonates. Seven percent (n = 120) were diagnosed with FGR at the time of adrenal measurement, and 14.7% (n = 251) experienced perinatal morbidity. EFW-corrected and absolute adrenal measurements were similar among fetuses with and without FGR as well as among those who did and did not experience morbidity. The area under the curve for corrected TAA was 0.52 (95% confidence interval 0.38-0.67). CONCLUSION: In our cohort, adrenal size was not associated with risk of morbidity among fetuses with FGR. Thieme. All rights reserved.
OBJECTIVE: Our objective was to test the association of fetal adrenal size with perinatal morbidity among fetuses with fetal growth restriction (FGR; estimated fetal weight [EFW] < 10th percentile). STUDY DESIGN: This was a secondary analysis of the Nulliparous Pregnancy Outcomes Study: Monitoring Mothers-to-be (nuMoM2b) adrenal study, which measured fetal adrenal gland size at 22 to 30 weeks' gestation. We analyzed the transverse adrenal area (TAA) and fetal zone area (absolute measurements and corrected for fetal size) and the ratio of the fetal zone area to the total transverse area using a composite perinatal outcome of stillbirth, neonatal intensive care unit admission, respiratory distress syndrome, necrotizing enterocolitis, retinopathy of prematurity, sepsis, mechanical ventilation, seizure, or death. Among fetuses with FGR, adrenal measurements were compared between those that did and did not experience the composite perinatal outcome. RESULTS: There were 1,709 eligible neonates. Seven percent (n = 120) were diagnosed with FGR at the time of adrenal measurement, and 14.7% (n = 251) experienced perinatal morbidity. EFW-corrected and absolute adrenal measurements were similar among fetuses with and without FGR as well as among those who did and did not experience morbidity. The area under the curve for corrected TAA was 0.52 (95% confidence interval 0.38-0.67). CONCLUSION: In our cohort, adrenal size was not associated with risk of morbidity among fetuses with FGR. Thieme. All rights reserved.
Authors: David M Haas; Corette B Parker; Deborah A Wing; Samuel Parry; William A Grobman; Brian M Mercer; Hyagriv N Simhan; Matthew K Hoffman; Robert M Silver; Pathik Wadhwa; Jay D Iams; Matthew A Koch; Steve N Caritis; Ronald J Wapner; M Sean Esplin; Michal A Elovitz; Tatiana Foroud; Alan M Peaceman; George R Saade; Marian Willinger; Uma M Reddy Journal: Am J Obstet Gynecol Date: 2015-01-31 Impact factor: 8.661
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Authors: Matthew K Hoffman; Ozhan M Turan; Corette B Parker; Ronald J Wapner; Deborah A Wing; David M Haas; M Sean Esplin; Samuel Parry; William A Grobman; Hyagriv N Simhan; Stephen Myers; Tommy E Holder; Pamela Rumney; Christian G Litton; Robert M Silver; Michal A Elovitz; Alan M Peaceman; Stephen Emery; Brian M Mercer; Matthew A Koch; George R Saade Journal: Obstet Gynecol Date: 2016-04 Impact factor: 7.661
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