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First-Trimester Uterine Artery Doppler for the Prediction of SGA at Birth: The Great Obstetrical Syndromes Study
- Source :
- Journal of Obstetrics and Gynaecology Canada. 40:1592-1599
- Publication Year :
- 2018
- Publisher :
- Elsevier BV, 2018.
-
Abstract
- To estimate the role of first-trimester uterine artery pulsatility index (UtA-PI) for the prediction of small-for-gestational age (SGA).We conducted a prospective cohort study of nulliparous women with singleton pregnancy (Great Obstetrical Syndromes study). UtA-PI was performed at 11 + 0 to 13 + 6 weeks and was reported in multiple of median (MoM). SGA was defined as birth weight below the 10th percentile and stratified as term or preterm SGA. Receiver operating characteristic curves analyses with their area under the curve (AUC) were used to estimate the predictive values of UtA-PI, alone and UtA-PI combined with maternal characteristics. We computed the detection rate and false-positive rate (FPR) of the SOGC SGA screening guidelines in our population.Of 4610 participants, SGA was identified in 486 pregnancies (10.3%), including 15 (0.3%) associated with preterm delivery. Compared with unaffected pregnancies, the mean log UtA-PI was significantly higher in term SGA and preterm SGA. The difference between preterm SGA and unaffected pregnancies remains significant after exclusion of SGA without preeclampsia. First-trimester UtA-PI was more predictive of preterm (AUC: 0.89) than term (AUC: 0.60) SGA (P 0.01). Combined with maternal characteristics, UtA-PI could have predicted 64% of preterm and 20% of term SGA (10% FPR). The SOGC guidelines criteria for early screening of SGA had a detection rate of 21% for a FPR of 21%.First-trimester UtA-PI can be used to predict SGA, but mainly preterm SGA. The current SOGC guidelines criteria for SGA screening are not efficient in nulliparous women.
- Subjects :
- Adult
congenital, hereditary, and neonatal diseases and abnormalities
medicine.medical_specialty
Birth weight
Population
Ultrasonography, Prenatal
Cohort Studies
03 medical and health sciences
0302 clinical medicine
Pre-Eclampsia
Predictive Value of Tests
Pregnancy
medicine.artery
medicine
Humans
False Positive Reactions
Prospective Studies
030212 general & internal medicine
education
Uterine artery
Prospective cohort study
reproductive and urinary physiology
education.field_of_study
Fetal Growth Retardation
030219 obstetrics & reproductive medicine
Receiver operating characteristic
Obstetrics
business.industry
Infant, Newborn
Quebec
Area under the curve
Obstetrics and Gynecology
medicine.disease
female genital diseases and pregnancy complications
Pregnancy Trimester, First
Uterine Artery
Area Under Curve
Pulsatile Flow
Infant, Small for Gestational Age
Small for gestational age
Female
business
Subjects
Details
- ISSN :
- 17012163
- Volume :
- 40
- Database :
- OpenAIRE
- Journal :
- Journal of Obstetrics and Gynaecology Canada
- Accession number :
- edsair.doi.dedup.....9126b341e50603ab8e90be51cb61ab99