Is the Cerebro-Placental Ratio Sufficient to Predict Adverse Neonatal Outcome in Small for Gestational Age Fetuses > 34 Weeks of Gestation?
Abstract
:1. Introduction
2. Materials and Methods
2.1. Study Design
2.2. Inclusion Criteria
2.3. Exclusion Criteria
2.4. Neonatal Outcome
2.5. Standard Clinical Management
2.6. Stasticial Analysis
3. Results
3.1. Demographic Data
3.2. Ultrasound Parameters
3.3. Neonatal Outcome
3.4. CPR Cutoff Value and EFW
3.5. Umbilical Artery PI
4. Discussion
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Variables | N (%) |
---|---|
Age (years) | 34 ± 6.8 |
Ethnicity (white) | 86 (84.3%) |
Primiparity | 60 (58.8%) |
Assisted reproductive technology | 3 (2.9%) |
Body mass index (BMI) ≥ 30kg/m2 | 5 (4.9%) |
Smoking | 23 (22.5%) |
Pre-gestational and gestational diabetes | 12 (11.8%) |
Hypertension (chronic and gestational) | 12 (11.7%) |
Renal disease | 2 (2%) |
Autoimmune disease | 3 (3%) |
Prophylactic aspirin intake | 8 (7.8%) |
Previous PE/HELLP | 6 (5.9%) |
Prior delivery with BW below the 10th centile and IUFD | 2 (1.9%) |
Prior delivery with BW below the 10th centile | 23 (22.5%) |
PE/HELLP in current pregnancy | 10 (9.8%) |
GA at birth (weeks ± days) | 37.6 ± 11.3 |
Delivery ≥ 37 weeks of gestation | 71 (70%) |
Mode of delivery | |
Spontaneous vaginal delivery | 34 (33.3%) |
Instrumental vaginal delivery | 9 (8.8%) |
Cesarean section | 59 (57.8%) |
Predicted/confirmed BW below 10th percentile | 90 (88%) |
Birth weight (g) | 2281 ± 388 |
Variables | N (%) |
---|---|
GA at diagnosis (weeks ± days) | 36.0 ± 1.1 |
GA at last ultrasound before delivery (weeks ± days) | 37.0 ± 1.4 |
EFW (g) | 2209 ± 366 |
EFW < 3rd percentile | 90 (88%) |
EFW < 10th and ≥ 3rd percentile | 9 (8.8%) |
EFW > 10th percentile CPR at last ultrasound before delivery | 3 (2.9%) 1.53 ± 0.5 |
Middle cerebral artery PI | 1.44 ± 0.3 |
Umbilical artery PI | 1.0 ± 0.3 |
Time interval between last ultrasound and delivery (days) | 3.31 ± 3.4 |
Variables | Adverse Outcome N = 43 | Good Outcome N = 59 | p Value |
---|---|---|---|
GA at last ultrasound (weeks ± days) | 36.1 ± 8.8 | 37.4 ± 8.5 | <0.001 |
Time interval last ultrasound to delivery (days) | 2.4 ± 2.8 | 4.0 ± 3.6 | 0.017 |
CPR at last ultrasound | 1.4 (0.49) | 1.6 (0.48) | 0.014 |
GA at delivery (weeks ± days) | 36.6 ± 10.0 | 38.4 ± 9.6 | <0.001 |
Preterm delivery (<37 weeks) | 24 (56%) | 7 (12%) | <0.001 |
Female gender | 21 (49%) | 36 (61%) | 0.23 |
Birth weight (g) | 2059 ± 361 | 2443 ± 325 | <0.001 |
Birth weight percentile groups (FGR) | |||
<3rd centile | 22 (51%) | 26 (44%) | |
<10th and ≥3rd percentile ≥10th percentile | 17 (40%) 4 (9.3%) | 28 (47%) 5 (8.5%) | |
Predicted/confirmed birth weight < 10th percentile | 38 (88%) | 52 (88%) | 1.00 |
Mode of delivery | |||
Spontaneous vaginal delivery | 9 (21%) | 25 (42%) | 0.033 |
Instrumental vaginal delivery | 4 (9.3%) | 5 (8.5%) | 1.00 |
Cesarean section | 30 (70%) | 29 (49%) | 0.044 |
Arterial cord pH | |||
pH < 7.15 | 6 (14%) | 0 (0.00%) | 0.005 |
Apgar at 5 min < 7 | 3 (7.0%) | 0 (0.00%) | 0.07 |
NICU admission | 34 (79%) | 0 (0.00%) | <0.001 |
Duration of NICU hospitalization | 10 (0–88) * | 0 | |
Neonatal morbidity (overall) | 32 (74%) | 0 (0.00%) | <0.001 |
Hypoglycemia | 15 (35%) | 0 (0.00%) | <0.001 |
Hyperbilirubinemia | 13 (30%) | 0 (0.00%) | <0.001 |
Respiratory distress syndrome | 8 (19%) | 0 (0.00%) | <0.001 |
Apnea-bradycardia | 7 (16%) | 0 (0.00%) | 0.002 |
Hypothermia | 2 (4.7%) | 0 (0.00%) | 0.18 |
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Zdanowicz, J.A.; Disler, M.; Gerull, R.; Raio, L.; Surbek, D. Is the Cerebro-Placental Ratio Sufficient to Predict Adverse Neonatal Outcome in Small for Gestational Age Fetuses > 34 Weeks of Gestation? Reprod. Med. 2021, 2, 2-11. https://doi.org/10.3390/reprodmed2010002
Zdanowicz JA, Disler M, Gerull R, Raio L, Surbek D. Is the Cerebro-Placental Ratio Sufficient to Predict Adverse Neonatal Outcome in Small for Gestational Age Fetuses > 34 Weeks of Gestation? Reproductive Medicine. 2021; 2(1):2-11. https://doi.org/10.3390/reprodmed2010002
Chicago/Turabian StyleZdanowicz, Jarmila A., Muriel Disler, Roland Gerull, Luigi Raio, and Daniel Surbek. 2021. "Is the Cerebro-Placental Ratio Sufficient to Predict Adverse Neonatal Outcome in Small for Gestational Age Fetuses > 34 Weeks of Gestation?" Reproductive Medicine 2, no. 1: 2-11. https://doi.org/10.3390/reprodmed2010002