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Fetal cerebral Doppler changes and outcome in late preterm fetal growth restriction: prospective cohort study

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Fetal cerebral Doppler changes and outcome in late preterm fetal growth restriction: prospective cohort study. / Stampalija, T; Thornton, J; Marlow, N; Napolitano, R; Bhide, A; Pickles, T; Bilardo, C M; Gordijn, S J; Gyselaers, W; Valensise, H; Hecher, K; Sande, R K; Lindgren, P; Bergman, E; Arabin, B; Breeze, A C; Wee, L; Ganzevoort, W; Richter, J; Berger, A; Brodszki, J; Derks, J; Mecacci, F; Maruotti, G M; Myklestad, K; Lobmaier, S M; Prefumo, F; Klaritsch, P; Calda, P; Ebbing, C; Frusca, T; Raio, L; Visser, G H A; Krofta, L; Cetin, I; Ferrazzi, E; Cesari, E; Wolf, H; Lees, C C; TRUFFLE Group.

in: ULTRASOUND OBST GYN, Jahrgang 56, Nr. 2, 08.2020, S. 173-181.

Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Zeitschriftenaufsatz › Forschung › Begutachtung

Harvard

Stampalija, T, Thornton, J, Marlow, N, Napolitano, R, Bhide, A, Pickles, T, Bilardo, CM, Gordijn, SJ, Gyselaers, W, Valensise, H, Hecher, K, Sande, RK, Lindgren, P, Bergman, E, Arabin, B, Breeze, AC, Wee, L, Ganzevoort, W, Richter, J, Berger, A, Brodszki, J, Derks, J, Mecacci, F, Maruotti, GM, Myklestad, K, Lobmaier, SM, Prefumo, F, Klaritsch, P, Calda, P, Ebbing, C, Frusca, T, Raio, L, Visser, GHA, Krofta, L, Cetin, I, Ferrazzi, E, Cesari, E, Wolf, H, Lees, CC & TRUFFLE Group 2020, 'Fetal cerebral Doppler changes and outcome in late preterm fetal growth restriction: prospective cohort study', ULTRASOUND OBST GYN, Jg. 56, Nr. 2, S. 173-181. https://doi.org/10.1002/uog.22125

APA

Stampalija, T., Thornton, J., Marlow, N., Napolitano, R., Bhide, A., Pickles, T., Bilardo, C. M., Gordijn, S. J., Gyselaers, W., Valensise, H., Hecher, K., Sande, R. K., Lindgren, P., Bergman, E., Arabin, B., Breeze, A. C., Wee, L., Ganzevoort, W., Richter, J., ... TRUFFLE Group (2020). Fetal cerebral Doppler changes and outcome in late preterm fetal growth restriction: prospective cohort study. ULTRASOUND OBST GYN, 56(2), 173-181. https://doi.org/10.1002/uog.22125

Vancouver

Stampalija T, Thornton J, Marlow N, Napolitano R, Bhide A, Pickles T et al. Fetal cerebral Doppler changes and outcome in late preterm fetal growth restriction: prospective cohort study. ULTRASOUND OBST GYN. 2020 Aug;56(2):173-181. https://doi.org/10.1002/uog.22125

Bibtex

@article{44cce4892be4477298661f024d0f8f45,
title = "Fetal cerebral Doppler changes and outcome in late preterm fetal growth restriction: prospective cohort study",
abstract = "OBJECTIVES: To explore the association between fetal umbilical and middle cerebral artery (MCA) Doppler abnormalities and outcome in late preterm pregnancies at risk of fetal growth restriction.METHODS: This was a prospective cohort study of singleton pregnancies at risk of fetal growth restriction at 32 + 0 to 36 + 6 weeks of gestation, enrolled in 33 European centers between 2017 and 2018, in which umbilical and fetal MCA Doppler velocimetry was performed. Pregnancies were considered at risk of fetal growth restriction if they had estimated fetal weight and/or abdominal circumference (AC) < 10th percentile, abnormal arterial Doppler and/or a fall in AC growth velocity of more than 40 percentile points from the 20-week scan. Composite adverse outcome comprised both immediate adverse birth outcome and major neonatal morbidity. Using a range of cut-off values, the association of MCA pulsatility index and umbilicocerebral ratio (UCR) with composite adverse outcome was explored.RESULTS: The study population comprised 856 women. There were two (0.2%) intrauterine deaths. Median gestational age at delivery was 38 (interquartile range (IQR), 37-39) weeks and birth weight was 2478 (IQR, 2140-2790) g. Compared with infants with normal outcome, those with composite adverse outcome (n = 93; 11%) were delivered at an earlier gestational age (36 vs 38 weeks) and had a lower birth weight (1900 vs 2540 g). The first Doppler observation of MCA pulsatility index < 5th percentile and UCR Z-score above gestational-age-specific thresholds (1.5 at 32-33 weeks and 1.0 at 34-36 weeks) had the highest relative risks (RR) for composite adverse outcome (RR 2.2 (95% CI, 1.5-3.2) and RR 2.0 (95% CI, 1.4-3.0), respectively). After adjustment for confounders, the association between UCR Z-score and composite adverse outcome remained significant, although gestational age at delivery and birth-weight Z-score had a stronger association.CONCLUSION: In this prospective multicenter study, signs of cerebral blood flow redistribution were found to be associated with adverse outcome in late preterm singleton pregnancies at risk of fetal growth restriction. Whether cerebral redistribution is a marker describing the severity of fetal growth restriction or an independent risk factor for adverse outcome remains unclear, and whether it is useful for clinical management can be answered only in a randomized trial. {\textcopyright} 2020 The Authors. Ultrasound in Obstetrics & Gynecology published by John Wiley & Sons Ltd on behalf of the International Society of Ultrasound in Obstetrics and Gynecology.",
author = "T Stampalija and J Thornton and N Marlow and R Napolitano and A Bhide and T Pickles and Bilardo, {C M} and Gordijn, {S J} and W Gyselaers and H Valensise and K Hecher and Sande, {R K} and P Lindgren and E Bergman and B Arabin and Breeze, {A C} and L Wee and W Ganzevoort and J Richter and A Berger and J Brodszki and J Derks and F Mecacci and Maruotti, {G M} and K Myklestad and Lobmaier, {S M} and F Prefumo and P Klaritsch and P Calda and C Ebbing and T Frusca and L Raio and Visser, {G H A} and L Krofta and I Cetin and E Ferrazzi and E Cesari and H Wolf and Lees, {C C} and {TRUFFLE Group}",
note = "{\textcopyright} 2020 The Authors. Ultrasound in Obstetrics & Gynecology published by John Wiley & Sons Ltd on behalf of the International Society of Ultrasound in Obstetrics and Gynecology.",
year = "2020",
month = aug,
doi = "10.1002/uog.22125",
language = "English",
volume = "56",
pages = "173--181",
journal = "ULTRASOUND OBST GYN",
issn = "0960-7692",
publisher = "John Wiley and Sons Ltd",
number = "2",

}

RIS

TY - JOUR

T1 - Fetal cerebral Doppler changes and outcome in late preterm fetal growth restriction: prospective cohort study

AU - Stampalija, T

AU - Thornton, J

AU - Marlow, N

AU - Napolitano, R

AU - Bhide, A

AU - Pickles, T

AU - Bilardo, C M

AU - Gordijn, S J

AU - Gyselaers, W

AU - Valensise, H

AU - Hecher, K

AU - Sande, R K

AU - Lindgren, P

AU - Bergman, E

AU - Arabin, B

AU - Breeze, A C

AU - Wee, L

AU - Ganzevoort, W

AU - Richter, J

AU - Berger, A

AU - Brodszki, J

AU - Derks, J

AU - Mecacci, F

AU - Maruotti, G M

AU - Myklestad, K

AU - Lobmaier, S M

AU - Prefumo, F

AU - Klaritsch, P

AU - Calda, P

AU - Ebbing, C

AU - Frusca, T

AU - Raio, L

AU - Visser, G H A

AU - Krofta, L

AU - Cetin, I

AU - Ferrazzi, E

AU - Cesari, E

AU - Wolf, H

AU - Lees, C C

AU - TRUFFLE Group

N1 - © 2020 The Authors. Ultrasound in Obstetrics & Gynecology published by John Wiley & Sons Ltd on behalf of the International Society of Ultrasound in Obstetrics and Gynecology.

PY - 2020/8

Y1 - 2020/8

N2 - OBJECTIVES: To explore the association between fetal umbilical and middle cerebral artery (MCA) Doppler abnormalities and outcome in late preterm pregnancies at risk of fetal growth restriction.METHODS: This was a prospective cohort study of singleton pregnancies at risk of fetal growth restriction at 32 + 0 to 36 + 6 weeks of gestation, enrolled in 33 European centers between 2017 and 2018, in which umbilical and fetal MCA Doppler velocimetry was performed. Pregnancies were considered at risk of fetal growth restriction if they had estimated fetal weight and/or abdominal circumference (AC) < 10th percentile, abnormal arterial Doppler and/or a fall in AC growth velocity of more than 40 percentile points from the 20-week scan. Composite adverse outcome comprised both immediate adverse birth outcome and major neonatal morbidity. Using a range of cut-off values, the association of MCA pulsatility index and umbilicocerebral ratio (UCR) with composite adverse outcome was explored.RESULTS: The study population comprised 856 women. There were two (0.2%) intrauterine deaths. Median gestational age at delivery was 38 (interquartile range (IQR), 37-39) weeks and birth weight was 2478 (IQR, 2140-2790) g. Compared with infants with normal outcome, those with composite adverse outcome (n = 93; 11%) were delivered at an earlier gestational age (36 vs 38 weeks) and had a lower birth weight (1900 vs 2540 g). The first Doppler observation of MCA pulsatility index < 5th percentile and UCR Z-score above gestational-age-specific thresholds (1.5 at 32-33 weeks and 1.0 at 34-36 weeks) had the highest relative risks (RR) for composite adverse outcome (RR 2.2 (95% CI, 1.5-3.2) and RR 2.0 (95% CI, 1.4-3.0), respectively). After adjustment for confounders, the association between UCR Z-score and composite adverse outcome remained significant, although gestational age at delivery and birth-weight Z-score had a stronger association.CONCLUSION: In this prospective multicenter study, signs of cerebral blood flow redistribution were found to be associated with adverse outcome in late preterm singleton pregnancies at risk of fetal growth restriction. Whether cerebral redistribution is a marker describing the severity of fetal growth restriction or an independent risk factor for adverse outcome remains unclear, and whether it is useful for clinical management can be answered only in a randomized trial. © 2020 The Authors. Ultrasound in Obstetrics & Gynecology published by John Wiley & Sons Ltd on behalf of the International Society of Ultrasound in Obstetrics and Gynecology.

AB - OBJECTIVES: To explore the association between fetal umbilical and middle cerebral artery (MCA) Doppler abnormalities and outcome in late preterm pregnancies at risk of fetal growth restriction.METHODS: This was a prospective cohort study of singleton pregnancies at risk of fetal growth restriction at 32 + 0 to 36 + 6 weeks of gestation, enrolled in 33 European centers between 2017 and 2018, in which umbilical and fetal MCA Doppler velocimetry was performed. Pregnancies were considered at risk of fetal growth restriction if they had estimated fetal weight and/or abdominal circumference (AC) < 10th percentile, abnormal arterial Doppler and/or a fall in AC growth velocity of more than 40 percentile points from the 20-week scan. Composite adverse outcome comprised both immediate adverse birth outcome and major neonatal morbidity. Using a range of cut-off values, the association of MCA pulsatility index and umbilicocerebral ratio (UCR) with composite adverse outcome was explored.RESULTS: The study population comprised 856 women. There were two (0.2%) intrauterine deaths. Median gestational age at delivery was 38 (interquartile range (IQR), 37-39) weeks and birth weight was 2478 (IQR, 2140-2790) g. Compared with infants with normal outcome, those with composite adverse outcome (n = 93; 11%) were delivered at an earlier gestational age (36 vs 38 weeks) and had a lower birth weight (1900 vs 2540 g). The first Doppler observation of MCA pulsatility index < 5th percentile and UCR Z-score above gestational-age-specific thresholds (1.5 at 32-33 weeks and 1.0 at 34-36 weeks) had the highest relative risks (RR) for composite adverse outcome (RR 2.2 (95% CI, 1.5-3.2) and RR 2.0 (95% CI, 1.4-3.0), respectively). After adjustment for confounders, the association between UCR Z-score and composite adverse outcome remained significant, although gestational age at delivery and birth-weight Z-score had a stronger association.CONCLUSION: In this prospective multicenter study, signs of cerebral blood flow redistribution were found to be associated with adverse outcome in late preterm singleton pregnancies at risk of fetal growth restriction. Whether cerebral redistribution is a marker describing the severity of fetal growth restriction or an independent risk factor for adverse outcome remains unclear, and whether it is useful for clinical management can be answered only in a randomized trial. © 2020 The Authors. Ultrasound in Obstetrics & Gynecology published by John Wiley & Sons Ltd on behalf of the International Society of Ultrasound in Obstetrics and Gynecology.

U2 - 10.1002/uog.22125

DO - 10.1002/uog.22125

M3 - SCORING: Journal article

C2 - 32557921

VL - 56

SP - 173

EP - 181

JO - ULTRASOUND OBST GYN

JF - ULTRASOUND OBST GYN

SN - 0960-7692

IS - 2

ER -