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First‐trimester screening for early and late small‐for‐gestational‐age neonates using maternal serum biochemistry, blood pressure and uterine artery Doppler
Author(s) -
Crovetto F.,
Crispi F.,
Scazzocchio E.,
Mercade I.,
Meler E.,
Figueras F.,
Gratacos E.
Publication year - 2014
Publication title -
ultrasound in obstetrics and gynecology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.202
H-Index - 141
eISSN - 1469-0705
pISSN - 0960-7692
DOI - 10.1002/uog.12537
Subject(s) - medicine , small for gestational age , uterine artery , obstetrics , eclampsia , gestation , gestational age , pregnancy , blood pressure , prospective cohort study , gynecology , genetics , biology
OBJECTIVE To assess the effectiveness of first‐trimester screening for early and late small‐for‐gestational‐age (SGA) neonates using maternal serum biochemistry, blood pressure and uterine artery Doppler . Methods This was a prospective study of 4970 women with a singleton pregnancy who underwent routine first‐trimester screening between 2009 and 2011. A logistic regression‐based predictive model for SGA , defined as birth weight < 10 th percentile, divided into early‐ or late‐onset based on gestational age at delivery before or after 34 weeks' gestation, was constructed. The model included maternal baseline characteristics: serum levels of pregnancy‐associated plasma protein‐A and free β‐human chorionic gonadotropin at 8–12 weeks and blood pressure and uterine artery Doppler at 11 + 0 to 13 + 6 weeks . Results The prevalence of early and late SGA was 0.6% and 7.9%, respectively. Association with pre‐eclampsia was 67% and 8%, respectively. At a false‐positive rate of 15%, the detection rate for early SGA was 73%; however it differed substantially for cases with and without pre‐eclampsia (90% vs 40%). For late SGA , at false‐positive rates of 15 and 50%, detection rates were 32% and 70%, respectively, and did not substantially differ between cases with and without pre‐eclampsia . Conclusions First‐trimester screening predicts early SGA mainly because of its strong association with pre‐eclampsia. Although prediction of late SGA was poorer, at a high false‐positive rate it might be considered as part of a first‐trimester strategy to select women requiring ultrasound assessment in the third trimester. Copyright © 2013 ISUOG. Published by John Wiley & Sons Ltd .