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Maternal demographics and hemodynamics for the prediction of fetal growth restriction at booking, in pregnancies at high risk for placental insufficiency.
- Source :
-
Acta obstetricia et gynecologica Scandinavica [Acta Obstet Gynecol Scand] 2016 Mar; Vol. 95 (3), pp. 329-38. Date of Electronic Publication: 2016 Jan 03. - Publication Year :
- 2016
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Abstract
- Introduction: Fetal growth restriction (FGR) is associated with poor perinatal outcomes. Screening and prevention tools for FGR, such as uterine artery Doppler imaging and aspirin, underperform in high-risk groups, compared with general antenatal populations. There is a paucity of sensitive screening tests for the early prediction of FGR in high-risk pregnancies.<br />Materials and Methods: This was a prospective observational study based in a dedicated antenatal hypertension clinic at a tertiary UK hospital. We assessed maternal demographic and central hemodynamic variables as predictors for FGR in a group of women at high risk for placental insufficiency due to chronic hypertension (n = 55) or a history of hypertension in a previous pregnancy (n = 71). Outcome variables were birthweight z-score as well as development of FGR (defined as birthweight below the 5th or 3rd centile). Maternal hemodynamics were assessed using a noninvasive transthoracic bioreactance monitor (Cheetah NICOM).<br />Results: The mean gestation at presentation was 13.6 (range: 8.5-19.5) weeks. Sixteen women delivered babies below the 5th centile. Ten of these were below the 3rd centile. Independent predictors of birthweight z-score were body surface area, peripheral vascular resistance and white ethnicity (R(2) = 0.26, p < 0.0001). Independent predictors of FGR were maternal height and cardiac output. The area under the receiver operator characteristic curve for prediction of FGR was 0.915 (95% CI 0.859-0.972) and 0.9079 (95% CI 0.823-0.990) for FGR below the 5th and 3rd centiles, respectively.<br />Conclusion: In women with chronic hypertension or a history of hypertension in a previous pregnancy, maternal size and cardiac output at booking provide a sensitive screening tool for FGR.<br /> (© 2015 Nordic Federation of Societies of Obstetrics and Gynecology.)
- Subjects :
- Adult
Area Under Curve
Body Height
Body Surface Area
Cardiac Output
Chronic Disease
Demography
Female
Fetal Growth Retardation ethnology
Fetal Growth Retardation etiology
Humans
Hypertension complications
Hypertension ethnology
Hypertension, Pregnancy-Induced physiopathology
Infant, Low Birth Weight
Infant, Newborn
Predictive Value of Tests
Pregnancy
Pregnancy, High-Risk
Prenatal Care
Prospective Studies
ROC Curve
Vascular Resistance
White People
Birth Weight
Fetal Growth Retardation diagnosis
Hypertension physiopathology
Subjects
Details
- Language :
- English
- ISSN :
- 1600-0412
- Volume :
- 95
- Issue :
- 3
- Database :
- MEDLINE
- Journal :
- Acta obstetricia et gynecologica Scandinavica
- Publication Type :
- Academic Journal
- Accession number :
- 26599800
- Full Text :
- https://doi.org/10.1111/aogs.12823