5 years ago

Longitudinal growth assessment for the prediction of adverse perinatal outcome in SGA-suspected fetuses

Eduard Gratacos, Tri Rahmat Basuki, Javier Caradeux, Francesc Figueras, Edurne Mazarico, Elisenda Eixarch
Background Fetal growth restriction (FGR) is associated with an increased risk of adverse perinatal outcome (APO). However, distinguishing this condition from smallness-for-gestational age remains elusive. A set of criteria has recently been proposed for such purpose, including the severity of smallness, Doppler parameters and growth velocity. Objectives To establish whether the use of growth velocity adds to Doppler evaluation in predicting APO among SGA-suspected fetuses. Methods A prospective cohort of consecutive singleton pregnancies with late (diagnosis > 32.0 weeks) SGA (estimated fetal weight [EFW] < 10th centile) was created. Longitudinal growth assessment was performed by calculation of the EFW z-velocity between diagnosis and last scan before delivery. The improvement in association and predictive performance for APO of EFW z-velocity was compared against standard criteria of FGR evaluated before delivery (EFW<3rd centile, abnormal uterine Doppler or abnormal cerebroplacental ratio). Result A total of 472 patients were prospectively evaluated for suspected SGA. Of them, 231 (48.9%) qualified as late FGR. Univariate analysis showed a significant trend towards higher frequency of EFW z-velocity in the lowest decile in pregnancies with APO (14.5% vs. 8.2%; p = 0.041). Nonetheless, the addition of z-velocity neither improved the association nor the prediction performance of standard criteria of FGR for the occurrence of APO. Conclusions Longitudinal assessment of fetal growth by means of z-velocity did not have any independent predictive value for adverse perinatal outcome when used in combination with Doppler in SGA-suspected fetuses.

Publisher URL: http://onlinelibrary.wiley.com/resolve/doi

DOI: 10.1002/uog.18824

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