OP06.10: The association between suboptimal fetal abdominal circumference growth velocity and adverse neonatal outcome in appropriate-for-gestational-age neonates

Introduction: Macrosomia is an emerging public health problem, both in the developed as well as in the developing countries. This study was aimed to examine the maternal and neonatal risk factors associated with macrosomia and compare adverse neonatal outcome between appropriate for gestational age (AGA) and macrosomia. Methods: Records of all live singleton AGA and macrosomic babies delivered at a tertiary care teaching hospital in Lalitpur, Nepal, between 14th April 2013 and 13th April 2014 were retrospectively reviewed. Results: Of the 769 deliveries, 684 neonates were eligible of which 93 were born macrosomic with an incidence of 12.1%. We observed the most significant neonatal outcome to be neonatal sepsis (14%; p = 0.005) compared to AGA babies (5.9%). Macrosomia was found to be associated with increasing maternal age and parity (p = 0.007) relative to mothers of AGA babies, most of whom underwent caesarean section (55.9%) whilst the same outcome was fewer for mothers of AGA babies (29.9%). A higher incidence of pregnancy induced hypertension (PIH) as maternal comorbidity (5.4%) was associated with macrosomia contrasted with mothers of AGA babies (4.4%). Conclusion: Macrosomic birth was found to be associated with relatively higher adverse neonatal outcome, warranting prolonged hospital admission than AGA births.

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EP18.19: Abdominal circumference growth velocity as an independent predictor of small‐for‐gestational‐age fetuses and the relationship with adverse perinatal outcomes

Ultrasound in Obstetrics and Gynecology ◽

10.1002/uog.21496 ◽

2019 ◽

Vol 54 (S1) ◽

pp. 348-349

Author(s):

N. Caner ◽

A. Serrano ◽

L. Perdomo ◽

M. Echevarria ◽

S. García ◽

...

Keyword(s):

Gestational Age ◽

Small For Gestational Age ◽

Growth Velocity ◽

Independent Predictor ◽

Perinatal Outcomes ◽

Abdominal Circumference ◽

Adverse Perinatal Outcomes ◽

The Relationship

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425: Multi-vessel Doppler parameters for the prediction of adverse neonatal outcome in the preterm growth-restricted fetus: does gestational age matter?

American Journal of Obstetrics and Gynecology ◽

10.1016/j.ajog.2012.10.591 ◽

2013 ◽

Vol 208 (1) ◽

pp. S186

Author(s):

Katherine Goetzinger ◽

Alison Cahill ◽

Linda Odibo ◽

George Macones ◽

Anthony Odibo

Keyword(s):

Gestational Age ◽

Neonatal Outcome ◽

Adverse Neonatal Outcome

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Using fetal abdominal circumference growth velocity in the prediction of adverse outcome in near-term small-for-gestational-age fetuses

Ultrasound in Obstetrics and Gynecology ◽

10.1002/uog.18988 ◽

2018 ◽

Vol 52 (4) ◽

pp. 494-500 ◽

Cited By ~ 7

Author(s):

A. Cavallaro ◽

M. Veglia ◽

E. Svirko ◽

S. Vannuccini ◽

G. Volpe ◽

...

Keyword(s):

Gestational Age ◽

Small For Gestational Age ◽

Growth Velocity ◽

Adverse Outcome ◽

Abdominal Circumference ◽

Near Term

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Prenatal sFlt-1/PlGF value for prediction of adverse neonatal outcome of isolated ultrasonic small-for-gestational-age fetus in normotensive pregnant women: A prospective cohort study

10.21203/rs.2.12396/v2 ◽

2019 ◽

Author(s):

So Hyun Shim ◽

Haeng Jun Jeon ◽

Hye Jin Ryu ◽

So Hyun Kim ◽

Seung Gi Min ◽

...

Keyword(s):

Gestational Age ◽

Small For Gestational Age ◽

Neonatal Outcome ◽

Adverse Outcome ◽

Control Group ◽

Third Trimester ◽

Cutoff Value ◽

Adverse Neonatal Outcome ◽

Increased Risk ◽

Plgf Ratio

Abstract Background: Not only preeclampsia but also small-for-gestational-age (SGA) neonates in the absence of preeclampsia are at increased risk of morbidity and mortality. Early recognition of fetuses at increased risk of being growth-restricted enables more appropriate surveillance and optimization of management for reduced risk of adverse neonatal outcomes. We investigated potential value of soluble fms-like tyrosine kinase-1 (sFlt-1) to placental growth factor (PlGF) ratio, estimated in late-second and early-third trimester respectively, for prediction of SGA neonates with poor neonatal outcome in the absence of preeclampsia. Methods: Included in this case control study were 530 singleton pregnant women who had attended the prenatal screening program at single institution between January 2011 and March 2012. Demographic and clinical information of maternal and neonatal data were collected. The sFlt-1/ PlGF value at 24 to 28+6 weeks and 29 to 36+6 weeks of gestation were analyzed for comparing appropriate for gestational age control group, SGA and SGA with poor neonatal group. Results: After excluding 22 preeclampsia cases, 47 SGA group and 461 control-group were included. Among SGA group, 17 neonates had adverse neonatal outcome (36.1%, 17/47). Mean gestational age at delivery in SGA group was 37.76±2.05 weeks, which showed no significant difference comparing to control group (38.43±2.1 weeks, p=0.122). The sFlt-1/PlGF ratios at late-second trimester were both higher in the SGA group and poor neonatal SGA group than control group (3.74±2.52 vs 6.73±8.22 vs 7.62±15.2, p=0.63) and especially sFlt-1/PlGF ratio at early-third trimester was significantly higher (14.41±12.5 vs 28.62±37.2 vs 109.12±83.96, p=0.002). As gestational age advances, rapid increase in sflt-1/PlGF ratio detected in poor SGA group comparing to SGA group with no adverse outcome. A cutoff value of 28.15 for the sFlt-1/PlGF ratio at 29 to 36+6weeks significantly predicted SGA neonates who had adverse outcome, with sensitivity and specificity of 76.9% and 88%, respectively. Conclusion: In this study, sFlt-1/PlGF ratio of SGA with adverse neonatal outcome group was significantly higher than control group. This study suggests the feasibility of the sFlt-1/PlGF ratio as helpful objective measurement for predicting the adverse SGA neonatal outcome by providing sFlt-1/PlGF cutoff value, besides ultrasound biometry measurement.

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Prenatal sFlt-1/PlGF value for prediction of adverse neonatal outcome of isolated ultrasonic small-for-gestational-age fetus in normotensive pregnant women: A prospective cohort study

10.21203/rs.2.12396/v1 ◽

2019 ◽

Author(s):

So Hyun Shim ◽

Haeng Jun Jeon ◽

Hye Jin Ryu ◽

So Hyun Kim ◽

Seung Gi Min ◽

...

Keyword(s):

Gestational Age ◽

Small For Gestational Age ◽

Neonatal Outcome ◽

Adverse Outcome ◽

Control Group ◽

Third Trimester ◽

Cutoff Value ◽

Adverse Neonatal Outcome ◽

Increased Risk ◽

Plgf Ratio

Abstract Background Not only preeclampsia but also small-for-gestational-age (SGA) neonates in the absence of preeclampsia are at increased risk of morbidity and mortality. Early recognition of fetuses at increased risk of being growth-restricted enables more appropriate surveillance and optimization of management for reduced risk of adverse neonatal outcomes. We investigated potential value of soluble fms-like tyrosine kinase-1 (sFlt-1) to placental growth factor (PlGF) ratio, estimated in late-second and early-third trimester respectively, for prediction of SGA neonates with poor neonatal outcome. Methods Included in this case control study were 530 singleton pregnant women who had attended the prenatal screening program at single institution between January 2011 and March 2012. The maternal serum levels of sFlt-1 and PlGF at 24 to 28+6weeks and 29 to 36+6weeks of gestation were measured for comparing control and SGA group. Results After excluding 22 preeclampsia cases, 47 SGA group and 461 control-group were included. Mean gestational age at delivery in SGA group was 37.76 ± 2.05weeks, which showed no significant difference comparing to control group (38.43 ± 2.1weeks, p=0.122). The sFlt-1/PlGF ratios at late-second trimester and early-third trimester were both higher in the SGA group than control group (7.62 vs 3.74, p=0.63; 28.62 vs 14.42, p=0.037) and especially sFlt-1/PlGF ratio at early-third trimester was significantly higher in the SGA group. Among SGA group, 17 neonates had adverse neonatal outcome (36.1%, 17/47). Both sFlt-1/PlGF ratios in each trimester were also higher in poor SGA group than control group (6.73 vs 3.77, p = 0.379; 109.12 vs 15.27, p=0.002). As gestational age advances, rapid increase in sflt-1/PlGF ratio detected in poor SGA group comparing to SGA group with no adverse outcome. A cutoff value of 28.15 for the sFlt-1/PlGF ratio at 29 to 36+6weeks significantly predicted SGA neonates who had adverse outcome, with sensitivity and specificity of 76.9% and 88%, respectively. Conclusion In this study, sFlt-1/PlGF ratio of SGA with adverse neonatal outcome group was significantly higher than control group. This study suggests the feasibility of the sFlt-1/PlGF ratio as helpful objective measurement for predicting the adverse SGA neonatal outcome by providing sFlt-1/PlGF cutoff value, besides ultrasound biometry measurement.

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