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Predictiveness of antenatal umbilical artery Doppler for adverse pregnancy outcome in small‐for‐gestational‐age babies according to customised birthweight centiles: population‐based study
Author(s) -
Figueras F,
Eixarch E,
Gratacos E,
Gardosi J
Publication year - 2008
Publication title -
bjog: an international journal of obstetrics and gynaecology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.157
H-Index - 164
eISSN - 1471-0528
pISSN - 1470-0328
DOI - 10.1111/j.1471-0528.2008.01670.x
Subject(s) - medicine , umbilical artery , obstetrics , small for gestational age , gestational age , fetus , pregnancy , population , genetics , environmental health , biology
Objective To examine the relationship between smallness at birth and the predictive value of umbilical artery Doppler. Design Retrospective cohort. Setting Tertiary referral university hospital, Barcelona. Population A total of 7645 singleton pregnancies delivered between January 2002 and June 2004. Methods The associations with adverse outcome were assessed for small‐for‐gestational‐age (SGA) babies according to customised standards who had normal and abnormal umbilical artery Doppler. Main outcome measures Neonatal morbidity and perinatal mortality. Results Of the 369 SGA fetuses that had been identified antenatally, 70 (19%) had an abnormal umbilical artery Doppler and the babies from these pregnancies had a higher risk for neonatal morbidity when compared with babies with normal birthweight (OR 3.99, 95% CI 1.04–11.03). However, the remaining 299 (81%) fetuses with normal umbilical artery Doppler also had an elevated risk of neonatal morbidity (OR 2.26, 95% CI 1.04–4.39). Overall, many of the instances of adverse outcome associated with smallness for gestational age were attributable to the group with normal Doppler than to the group with abnormal Doppler. Conclusion Normal antenatal umbilical artery Doppler cannot be taken as an indicator of low risk in pregnancies where the fetus is SGA according to customised percentiles.