Abdominal circumference growth velocity as a predictor of adverse perinatal outcomes in small-for-gestational-age fetuses.

Autor: Rodriguez-Sibaja MJ; Maternal-Fetal Medicine Division, Instituto Nacional de Perinatologia, Mexico City, Mexico., Villa-Cueva A; Maternal-Fetal Medicine Division, Instituto Nacional de Perinatologia, Mexico City, Mexico., Ochoa-Padilla M; Maternal-Fetal Medicine Division, Instituto Nacional de Perinatologia, Mexico City, Mexico., Rodriguez-Montenegro MS; Maternal-Fetal Medicine Division, Instituto Nacional de Perinatologia, Mexico City, Mexico., Lumbreras-Marquez MI; Department of Epidemiology and Public Health, Universidad Panamericana School of Medicine, Mexico City, Mexico., Acevedo-Gallegos S; Maternal-Fetal Medicine Division, Instituto Nacional de Perinatologia, Mexico City, Mexico., Gallardo-Gaona JM; Maternal-Fetal Medicine Division, Instituto Nacional de Perinatologia, Mexico City, Mexico., Copado-Mendoza Y; Maternal-Fetal Medicine Division, Instituto Nacional de Perinatologia, Mexico City, Mexico.
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] 2023 Dec; Vol. 36 (2), pp. 2262077. Date of Electronic Publication: 2023 Sep 26.
DOI: 10.1080/14767058.2023.2262077
Abstrakt: Objective: To assess the predictive value of abdominal circumference growth velocity (ACGV) between the second and third trimesters to predict adverse perinatal outcomes in a cohort of small-for-gestational-age fetuses without evidence of placental insufficiency (i.e. fetal growth restriction).
Material and Methods: This is a single-center retrospective cohort study of all singleton pregnancies with small-for-gestational-age fetuses diagnosed and delivered at a quaternary institution. Crude and adjusted odds ratios (ORs) and corresponding confidence intervals (CIs) were calculated via logistic regression models to assess the potential association between abnormal ACGV (i.e. ≤10th centile) and adverse perinatal outcomes defined as a composite outcome (i.e. umbilical artery pH <7.1, 5-min Apgar score <7, admission to the neonatal intensive care unit, hypoglycemia, intrapartum fetal distress requiring expedited delivery, and perinatal death). Furthermore, the area under the receiver-operating characteristic curve (AUC) of three logistic regression models based on estimated fetal weight and ACGV for predicting the composite outcome is also reported.
Results: A total of 154 pregnancies were included for analysis. The median birthweight for the cohort was 2,437 g (interquartile range [IQR] 2280, 2635). Overall, the primary composite outcome was relatively common (29.2%). In addition, there was a significant association between abnormal ACGV and adverse perinatal outcomes (OR 3.37, 95% CI 1.60, 7.13; adjusted OR 4.30, 95% CI 1.77, 10.49). Likewise, the AUC for the ACGV was marginally higher (0.64) than the estimated fetal weight (0.54) and ACGV + estimated fetal weight (0.54). Still, no significant difference was detected between the curves ( p  = 0.297).
Conclusions: Our results suggest that an ACGV below the 10th centile is a risk factor for adverse perinatal outcomes among small-for-gestational-age fetuses.
Databáze: MEDLINE
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