Predicting singleton antepartum stillbirth by the demographic Fetal Medicine Foundation Risk Calculator-A retrospective case-control study.
Autor: | Muin DA; Division of Feto-Maternal Medicine, Department of Obstetrics and Gynaecology, Comprehensive Centre for Pediatrics, Medical University of Vienna, Vienna, Austria., Windsperger K; Division of Feto-Maternal Medicine, Department of Obstetrics and Gynaecology, Comprehensive Centre for Pediatrics, Medical University of Vienna, Vienna, Austria., Attia N; Division of Feto-Maternal Medicine, Department of Obstetrics and Gynaecology, Comprehensive Centre for Pediatrics, Medical University of Vienna, Vienna, Austria., Kiss H; Division of Feto-Maternal Medicine, Department of Obstetrics and Gynaecology, Comprehensive Centre for Pediatrics, Medical University of Vienna, Vienna, Austria. |
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Jazyk: | angličtina |
Zdroj: | PloS one [PLoS One] 2022 Jan 20; Vol. 17 (1), pp. e0260964. Date of Electronic Publication: 2022 Jan 20 (Print Publication: 2022). |
DOI: | 10.1371/journal.pone.0260964 |
Abstrakt: | Objective: To assess the risk of singleton intrauterine fetal death (IUFD) in women by the demographic setting of the online Fetal Medicine Foundation (FMF) Stillbirth Risk Calculator. Methods: Retrospective single-centre case-control study involving 144 women having suffered IUFD and 247 women after delivery of a live-born singleton. Nonparametric receiver operating characteristics (ROC) analyses were performed to predict the prognostic power of the FMF Stillbirth risk score and to generate a cut-off value to discriminate best between the event of IUFD versus live birth. Results: Women in the IUFD cohort born a significantly higher overall risk with a median FMF risk score of 0.45% (IQR 0.23-0.99) compared to controls [0.23% (IQR 0.21-0.29); p<0.001]. Demographic factors contributing to an increased risk of IUFD in our cohort were maternal obesity (p = 0.002), smoking (p<0.001), chronic hypertension (p = 0.015), antiphospholipid syndrome (p = 0.017), type 2 diabetes (p<0.001), and insulin requirement (p<0.001). ROC analyses showed an area under the curve (AUC) of 0.72 (95% CI 0.67-0.78; p<0.001) for predicting overall IUFD and an AUC of 0.72 (95% CI 0.64-0.80; p<0.001), respectively, for predicting IUFD excluding congenital malformations. The FMF risk score at a cut-off of 0.34% (OR 6.22; 95% CI 3.91-9.89; p<0.001) yielded an 82% specificity and 58% sensitivity in predicting IUFD with a positive and negative predictive value of 0.94% and 99.84%, respectively. Conclusion: The FMF Stillbirth Risk Calculator based upon maternal demographic and obstetric characteristics only may help identify women at low risk of antepartum stillbirth. Competing Interests: The authors have declared that no competing interests exist. |
Databáze: | MEDLINE |
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