Second‐ to third‐trimester longitudinal growth assessment for prediction of small‐for‐gestational age and late fetal growth restriction

Autor: E. Gratacós, Javier Caradeux, Elisenda Eixarch, F. Figueras, E. Mazarico, Tri Rahmat Basuki
Rok vydání: 2018
Předmět:
Adult
medicine.medical_specialty
Pregnancy Trimester
Third
Gestational Age
longitudinal growth
Logistic regression
Third trimester
Ultrasonography
Prenatal
fetal growth
03 medical and health sciences
0302 clinical medicine
Predictive Value of Tests
Pregnancy
Fetal growth
medicine
Humans
Radiology
Nuclear Medicine and imaging
Prospective Studies
030212 general & internal medicine
Prospective cohort study
Analysis of Variance
Fetus
Fetal Growth Retardation
fetal growth restriction
030219 obstetrics & reproductive medicine
Radiological and Ultrasound Technology
Singleton
Obstetrics
business.industry
Longitudinal growth
Infant
Newborn
Obstetrics and Gynecology
small-for-gestational age
General Medicine
ultrasound
medicine.disease
ROC Curve
Reproductive Medicine
Spain
Pregnancy Trimester
Second
Infant
Small for Gestational Age
Small for gestational age
Female
business
Zdroj: ULTRASOUND IN OBSTETRICS & GYNECOLOGY
r-FSJD: Repositorio Institucional de Producción Científica de la Fundació Sant Joan de Déu
Fundació Sant Joan de Déu
Ultrasound in obstetrics & gynecology : the official journal of the International Society of Ultrasound in Obstetrics and Gynecology
r-FSJD. Repositorio Institucional de Producción Científica de la Fundació Sant Joan de Déu
instname
ISSN: 1469-0705
0960-7692
DOI: 10.1002/uog.17471
Popis: OBJECTIVE: Detection of fetal growth restriction (FGR) remains poor and most screening strategies rely on cross-sectional evaluation of fetal size during the third trimester. A longitudinal and individualized approach has been proposed as an alternative method of evaluation. The aim of this study was to compare second- to third-trimester longitudinal growth assessment to cross-sectional evaluation in the third trimester for the prediction of small-for-gestational age (SGA) and late FGR in low-risk singleton pregnancy. METHODS: This was a prospective cohort study of 2696 unselected consecutive low-risk singleton pregnancies scanned at 21 ± 2 and 32 ± 2 weeks. For cross-sectional growth assessment, abdominal circumference (AC) measurements were transformed to z-values according the 21st-INTERGROWTH standards. Longitudinal growth assessment was performed by calculating the AC z-velocity and the second- to third-trimester AC conditional growth centile. Longitudinal assessment was compared with cross-sectional assessment at 32 weeks. Association of cross-sectional and longitudinal evaluations with SGA and late FGR was assessed by logistic regression analysis. Predictive performance was determined by receiver-operating characteristics curve analysis. RESULT: In total, 210 (7.8%) newborns were classified as SGA and 103 (3.8%) as late FGR. Neither longitudinal measurement improved the association with SGA or late FGR provided by cross-sectional evaluation of AC z-score at 32 weeks. Areas under the curves of AC z-velocity and conditional AC growth were significantly smaller than those of cross-sectional AC z-scores (P < 0.001), although AC z-velocity performed significantly better than did conditional AC growth (P < 0.001). CONCLUSION: Longitudinal assessment of fetal growth from the second to third trimester has a low predictive capacity for SGA and late FGR in low-risk singleton pregnancy compared with cross-sectional growth evaluation. Copyright © 2017 ISUOG. Published by John Wiley & Sons Ltd.
Databáze: OpenAIRE
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