Δημοσίευση

First-trimester and combined first- and second-trimester prediction of small-for-gestational age and fetuses with late growth restriction.

ΤίτλοςFirst-trimester and combined first- and second-trimester prediction of small-for-gestational age and fetuses with late growth restriction.
Publication TypeJournal Article
Year of Publication2018
AuthorsSotiriadis, A., Figueras F., Eleftheriades M., Papaioannou G. K., Chorozoglou G., Dinas K., & Papantoniou N.
JournalUltrasound Obstet Gynecol
Date Published2018 Mar 24
ISSN1469-0705
Abstract

AIM: To develop a first-trimester or combined first- and second-trimester screening algorithm for the prediction of small-for-gestational age (SGA) and late growth-restriction (FGR).METHODS: This was a retrospective study of pregnant women with singleton pregnancy, who attended routine first- second- and third-trimester ultrasound scan. Late FGR was defined, at ≥32 weeks in the absence of congenital anomalies as, either (a) estimated fetal weight (EFW) or birthweight (BW) <3 centile , OR (b) EFW<10 centile and either uterine artery mean PI >95 centile or cerebroplacental ratio (CPR) <5 centile. Neonates with birthweight <10 centile, regardless from prenatal parameters, were defined as SGA. The predictive effectiveness of maternal, first- and second-trimester factors was tested using logistic regression and ROC curve analysis.RESULTS: A total of 3520 fetuses were included (late FGR n=109 [3.1%], SGA n=292 [8.3%]). Of the late FGR cases, 56 (1.6%) fulfilled the antenatal criteria (EFW<3 centile or EFW<10 centile plus abnormal uterine artery resistance or CPR) and were defined as prenatally detected late FGR. First-trimester screening (conception, smoking, maternal height, PAPP-A, uterine artery PI) could predict 50.0% of the prenatally diagnosed and 36.7% of overall late FGR fetuses for 10% false positive rate. Combined first- and second-trimester screening (conception, smoking, PAPP-A, second- trimester EFW, HC/AC ratio and uterine artery PI) could predict 78.6% of the prenatally detected and 59.6% of overall late FGR fetuses, for 10% false positive rate (area under the curve 0.901, 95%CI 0.856-0.947; and 0.855, 95%CI 0.818-0.8916, respectively). The prediction of SGA was suboptimal for both first-trimester and combined screening.CONCLUSIONS: A simple model combining maternal, first- and second-trimester predictors can detect 60% of fetuses who will develop late FGR, and 79% of those fetuses who will be prenatally classified as late FGR, for a 10% of false positive rate.

DOI10.1002/uog.19055
Alternate JournalUltrasound Obstet Gynecol
PubMed ID29573501

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