Prediction of late-onset fetal growth restriction using a combined first- and second-trimester screening model

Abstract Background Prediction models for early and late fetal growth restriction (FGR) have been established in many high-income countries. However, prediction models for late FGR in China are limited. This study aimed to develop a simple combined first- and second-trimester prediction model for screening late-onset FGR in South Chinese infants.Methods This retrospective study included 2258 women who had singleton pregnancies and received routine ultrasound scans. Late-onset FGR was defined as a birth weight < the 10th percentile plus abnormal Doppler indices and/or a birth weight below the 3rd percentile after 32 weeks, regardless of the Doppler status. Multivariate logistic regression was used to develop a prediction model.Results Ninety-three fetuses were identified as late-onset FGR. The significant predictors for late-onset FGR were maternal age, height, weight, and medical history; the second-trimester head circumference (HC)/abdominal circumference (AC) ratio; and the estimated fetal weight (EFW). This model achieved a detection rate (DR) of 52.6% for late-onset FGR at a 10% false positive rate (FPR) (area under the curve (AUC): 0.80, 95%CI 0.76-0.85).Conclusions A multivariate model combining first- and second-trimester default tests can detect 52.6% of cases of late-onset FGR. Further studies with more screening markers are needed to improve the detection rate.

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First-trimester screening with specific algorithms for early- and late-onset fetal growth restriction

Ultrasound in Obstetrics and Gynecology ◽

10.1002/uog.15879 ◽

2016 ◽

Vol 48 (3) ◽

pp. 340-348 ◽

Cited By ~ 38

Author(s):

F. Crovetto ◽

S. Triunfo ◽

F. Crispi ◽

V. Rodriguez-Sureda ◽

E. Roma ◽

...

Keyword(s):

Fetal Growth ◽

Fetal Growth Restriction ◽

Late Onset ◽

First Trimester ◽

Growth Restriction ◽

First Trimester Screening ◽

Trimester Screening

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Risk stratification for early-onset fetal growth restriction in women with abnormal serum biomarkers: a retrospective cohort study

Scientific Reports ◽

10.1038/s41598-020-78631-5 ◽

2020 ◽

Vol 10 (1) ◽

Author(s):

L. Ormesher ◽

L. Warrander ◽

Y. Liu ◽

S. Thomas ◽

L. Simcox ◽

...

Keyword(s):

Fetal Growth ◽

Fetal Growth Restriction ◽

Early Onset ◽

Late Onset ◽

Area Under The Curve ◽

Maternal Serum ◽

Serum Biomarkers ◽

Growth Restriction ◽

Aneuploidy Screening ◽

Internal Validation

AbstractAbnormal maternal serum biomarkers (AMSB), identified through the aneuploidy screening programme, are frequent incidental findings in pregnancy. They are associated with fetal growth restriction (FGR), but previous studies have not examined whether this association is with early-onset (< 34 weeks) or late-onset (> 34 weeks) FGR; as a result there is no consensus on management. The aims of this study were to determine the prevalence and phenotype of FGR in women with AMSB and test the predictive value of placental sonographic screening to predict early-onset FGR. 1196 pregnant women with AMSB underwent a 21–24 week “placental screen” comprising fetal and placental size, and uterine artery Doppler. Multivariable regression was used to calculate a predictive model for early-onset FGR (birthweight centile < 3rd/< 10th with absent umbilical end-diastolic flow, < 34 weeks). FGR prevalence was high (10.3%), however early-onset FGR was uncommon (2.3%). Placental screening effectively identified early-onset (area under the curve (AUC) 0.93, 95% confidence interval (CI) 0.87–1.00), but not late-onset FGR (AUC 0.70, 95% CI 0.64–0.75). Internal validation demonstrated robust performance for detection/exclusion of early-onset FGR. In this cohort, utilisation of our proposed algorithm with targeted fetal growth and Doppler surveillance, compared with universal comprehensive surveillance would have avoided 1044 scans, potentiating significant cost-saving for maternity services.

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Physiopathology of late-onset fetal growth restriction

Minerva Obstetrics and Gynecology ◽

10.23736/s2724-606x.21.04771-7 ◽

2021 ◽

Vol 73 (4) ◽

Author(s):

Edward ARAUJO JÚNIOR ◽

Ana C. ZAMARIAN ◽

Ana C. CAETANO ◽

Alberto B. PEIXOTO ◽

Luciano M. NARDOZZA

Keyword(s):

Fetal Growth ◽

Fetal Growth Restriction ◽

Late Onset ◽

Growth Restriction

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miR-16-5p, miR-103-3p, and miR-27b-3p as Early Peripheral Biomarkers of Fetal Growth Restriction

Frontiers in Pediatrics ◽

10.3389/fped.2021.611112 ◽

2021 ◽

Vol 9 ◽

Author(s):

Salvatore Tagliaferri ◽

Pasquale Cepparulo ◽

Antonio Vinciguerra ◽

Marta Campanile ◽

Giuseppina Esposito ◽

...

Keyword(s):

Fetal Growth ◽

Gestational Age ◽

Fetal Growth Restriction ◽

Late Onset ◽

Maternal Blood ◽

Growth Restriction ◽

Therapeutic Interventions ◽

Control Group ◽

Fetal Hypoxia ◽

Blood Samples

Current tests available to diagnose fetal hypoxia in-utero lack sensitivity thus failing to identify many fetuses at risk. Emerging evidence suggests that microRNAs derived from the placenta circulate in the maternal blood during pregnancy and may be used as non-invasive biomarkers for pregnancy complications. With the intent to identify putative markers of fetal growth restriction (FGR) and new therapeutic druggable targets, we examined, in maternal blood samples, the expression of a group of microRNAs, known to be regulated by hypoxia. The expression of microRNAs was evaluated in maternal plasma samples collected from (1) women carrying a preterm FGR fetus (FGR group) or (2) women with an appropriately grown fetus matched at the same gestational age (Control group). To discriminate between early- and late-onset FGR, the study population was divided into two subgroups according to the gestational age at delivery. Four microRNAs were identified as possible candidates for the diagnosis of FGR: miR-16-5p, miR-103-3p, miR-107-3p, and miR-27b-3p. All four selected miRNAs, measured by RT-PCR, resulted upregulated in FGR blood samples before the 32nd week of gestation. By contrast, miRNA103-3p and miRNA107-3p, analyzed between the 32nd and 37th week of gestation, showed lower expression in the FGR group compared to aged matched controls. Our results showed that measurement of miRNAs in maternal blood may form the basis for a future diagnostic test to determine the degree of fetal hypoxia in FGR, thus allowing the start of appropriate therapeutic interventions to alleviate the burden of this disease.

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EARLY MARKERS OF DIAGNOSIS FETAL GROWTH RESTRICTION SYNDROME

Reproductive Medicine ◽

10.37800/rm2020-1-23(2) ◽

2020 ◽

pp. 48-51

Author(s):

G.A. Ikhtiyarova ◽

M.J. Aslonova ◽

N.K. Dustova

Keyword(s):

Blood Flow ◽

Fetal Growth ◽

Fetal Growth Restriction ◽

Growth Restriction ◽

Second Trimester ◽

Early Markers ◽

Uteroplacental Blood Flow ◽

Placental Blood ◽

Placental Blood Flow ◽

Large Vessels

The article presents the effectiveness of Dopplerometry for assessing blood flow in large vessels, including the umbilical, uterine artery and middle cerebral artery, 90 women were examined in the second trimester, and 45 women showed signs of placental insufficiency, such as fetal growth restriction syndrome at 28-34 weeks. The results of the study showed that 23 (51.1%) women had signs of subcompensated insufficiency of uteroplacental blood flow, and 11 (24.4%) women showed signs of fetal-placental blood flow. The study of the uteroplacental-fetal blood flow allows early detection of early signs of impairment in the fetoplacental system and its timely correction.

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