Objective To identify independent predictors of adverse neonatal outcome in cases of fetal growth restriction (FGR) at >= 34 weeks.Methods From a cohort of 481 FGR cases delivered at >= 34 weeks, demographic and obstetric variables, fetal biometry and Doppler indices of the uterine, umbilical and fetal middle cerebral arteries available within 2 weeks of delivery, were related to adverse neonatal outcome, defined as admission to the neonatal intensive care unit for indications other than low birth weight alone.Results Logistic regression analysis showed that gestational age (GA) at delivery (odds ratio (OR) = 0.59; 95% Cl, 0.50-0.70), abdominal circumference (AC) centile (OR = 0.69; 95% CI, 0.59-0.81) and umbilical artery (UA) pulsatility index (PI) centile (OR = 1.02; 95% CI, 1.01-1.04) significantly correlated with adverse neonatal outcome. From this model we calculated a score of adverse neonatal outcome expressed by the formula: (UA-PI centile/3) (10 x AC centile) + (10 x (40 GA at delivery in weeks)). Receiver operating characteristics curve analysis demonstrated that a score of >= 25 optimally predicted adverse neonatal outcome (sensitivity of 75%, false-positive rate of 18%). Beyond 37.5 weeks, gestational age no longer had an independent impact on outcome.Conclusions In late preterm or term FGR, GA at delivery is the most important predictor of adverse neonatal outcome. At > 37.5 weeks, delivery may be the best option to minimize adverse outcome in all FGR cases. At 34-37 weeks, a score based on GA at delivery, UA-PI centile and AC centile optimally predicts adverse neonatal outcome. Copyright (C) 2010 ISUOG. Published by John Wiley & Sons, Ltd.

Vergani, P., Roncaglia, N., Ghidini, A., Crippa, I., Cameroni, I., Orsenigo, F., et al. (2010). Can we predict adverse neonatal outcome in late preterm or term fetal growth restriction?. ULTRASOUND IN OBSTETRICS & GYNECOLOGY, 36(2), 166-170 [10.1002/uog.7583].

Can we predict adverse neonatal outcome in late preterm or term fetal growth restriction?

VERGANI, PATRIZIA;CRIPPA, ISABELLA;CAMERONI, IRENE;
2010

Abstract

Objective To identify independent predictors of adverse neonatal outcome in cases of fetal growth restriction (FGR) at >= 34 weeks.Methods From a cohort of 481 FGR cases delivered at >= 34 weeks, demographic and obstetric variables, fetal biometry and Doppler indices of the uterine, umbilical and fetal middle cerebral arteries available within 2 weeks of delivery, were related to adverse neonatal outcome, defined as admission to the neonatal intensive care unit for indications other than low birth weight alone.Results Logistic regression analysis showed that gestational age (GA) at delivery (odds ratio (OR) = 0.59; 95% Cl, 0.50-0.70), abdominal circumference (AC) centile (OR = 0.69; 95% CI, 0.59-0.81) and umbilical artery (UA) pulsatility index (PI) centile (OR = 1.02; 95% CI, 1.01-1.04) significantly correlated with adverse neonatal outcome. From this model we calculated a score of adverse neonatal outcome expressed by the formula: (UA-PI centile/3) (10 x AC centile) + (10 x (40 GA at delivery in weeks)). Receiver operating characteristics curve analysis demonstrated that a score of >= 25 optimally predicted adverse neonatal outcome (sensitivity of 75%, false-positive rate of 18%). Beyond 37.5 weeks, gestational age no longer had an independent impact on outcome.Conclusions In late preterm or term FGR, GA at delivery is the most important predictor of adverse neonatal outcome. At > 37.5 weeks, delivery may be the best option to minimize adverse outcome in all FGR cases. At 34-37 weeks, a score based on GA at delivery, UA-PI centile and AC centile optimally predicts adverse neonatal outcome. Copyright (C) 2010 ISUOG. Published by John Wiley & Sons, Ltd.
Articolo in rivista - Articolo scientifico
fetal grow restriction, doppler
English
2010
36
2
166
170
none
Vergani, P., Roncaglia, N., Ghidini, A., Crippa, I., Cameroni, I., Orsenigo, F., et al. (2010). Can we predict adverse neonatal outcome in late preterm or term fetal growth restriction?. ULTRASOUND IN OBSTETRICS & GYNECOLOGY, 36(2), 166-170 [10.1002/uog.7583].
File in questo prodotto:
Non ci sono file associati a questo prodotto.

I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.

Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/10281/9533
Citazioni
  • Scopus 22
  • ???jsp.display-item.citation.isi??? 19
Social impact