A structurally normal fetus at the 11- to 14-week ultrasound does not guarantee a newborn without congenital anomalies: a cohort study.

Autor:	Mario Sarti A Junior; a Department of Gynecology and Obstetrics , Ribeirão Preto Medical School, University of São Paulo , Ribeirão Preto , Brazil and., Okido MM; a Department of Gynecology and Obstetrics , Ribeirão Preto Medical School, University of São Paulo , Ribeirão Preto , Brazil and., Araujo Júnior E; b Department of Obstetrics , Paulista School of Medicine - Federal University of São Paulo , São Paulo , Brazil., Cavalli Rde C; a Department of Gynecology and Obstetrics , Ribeirão Preto Medical School, University of São Paulo , Ribeirão Preto , Brazil and., Quintana SM; a Department of Gynecology and Obstetrics , Ribeirão Preto Medical School, University of São Paulo , Ribeirão Preto , Brazil and., Duarte G; a Department of Gynecology and Obstetrics , Ribeirão Preto Medical School, University of São Paulo , Ribeirão Preto , Brazil and., Marcolin AC; a Department of Gynecology and Obstetrics , Ribeirão Preto Medical School, University of São Paulo , Ribeirão Preto , Brazil and.
Jazyk:	angličtina
Zdroj:	The journal of maternal-fetal & neonatal medicine : the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians [J Matern Fetal Neonatal Med] 2016 Dec; Vol. 29 (24), pp. 3960-6. Date of Electronic Publication: 2016 Mar 03.
DOI:	10.3109/14767058.2016.1152246
Abstrakt:	Objective: The objective of this study was to analyze the influence of maternal demographic characteristics and abnormal first-trimester sonographic markers on congenital anomalies (CAs) at birth when the fetus is structurally normal at the 11- to 14-week ultrasound. Methods: This prospective cohort study comprised high-risk women undergoing routine antenatal care. Detailed assessments of fetal anatomy and first-trimester sonographic markers were performed at 11-14 weeks of pregnancy. Multilevel regression analysis was used to determine the effects of maternal characteristics and abnormal first-trimester sonographic markers on the incidence of CA at birth. Results: Three hundred and ten patients were evaluated, and 41 patients (13.2%) had an anomalous newborn. The presence of a specific indication at the first-trimester ultrasound (OR: 2.72; CI 95% 1.09-6.74) or a nuchal translucency (NT) thickness greater than 2.5 mm increased the risk of CA at birth by three fold (OR: 3.10; CI 95% 1.07-9.59). High adjusted risks for trisomies 21, 18 and 13 increased the likelihood of having a structurally abnormal newborn by five, twelve and six fold, respectively. Conclusion: Increased NT and/or high adjusted risks for trisomies 21, 18, and 13 increase the risk of CA at birth, even in fetuses with a structurally normal 11- to 14-week ultrasound scan.
Databáze:	MEDLINE
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