sFlt-1/PlGF Ratio in Prediction of Short-Term Neonatal Outcome of Small for Gestational Age Neonates

Background: Small for gestational age is a pregnancy complication associated with a variety of adverse perinatal outcomes. The aim of the study was to investigate if sFlt-1/PlGF ratio is related to adverse short-term neonatal outcome in neonates small for gestational age in normotensive pregnancy. Methods: A prospective observational study was conducted. Serum sFlt-1/PlGF ratio was measured in women in singleton gestation diagnosed with fetus small for gestational age. Short-term neonatal outcome analyzed in the period between birth and discharge home. Results: Eighty-two women were included. Women with sFlt-1/PlGF ratio ≥33 gave birth to neonates with lower birthweight at lower gestational age. Neonates from high ratio group suffered from respiratory disorders and NEC significantly more often. They were hospitalized at NICU more often and were discharged home significantly later. sFlt-1/PlGF ratio predicted combined neonatal outcome with sensitivity of 73% and specificity of 82.2%. Conclusions: sFlt-1/PlGF ratio is a useful toll in prediction of short-term adverse neonatal outcome in SGA pregnancies.

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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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Doppler measurements of both umbilical arteries do not improve predictive value for adverse perinatal outcomes in small-for-gestational age fetuses

European Journal of Obstetrics & Gynecology and Reproductive Biology ◽

10.1016/j.ejogrb.2018.10.040 ◽

2018 ◽

Vol 231 ◽

pp. 169-173

Author(s):

Charlotte A. Vollgraff Heidweiller-Schreurs ◽

Ninieck E. van Maasakker ◽

Peter M. van de Ven ◽

Christianne J.M. de Groot ◽

Caroline J. Bax ◽

...

Keyword(s):

Gestational Age ◽

Small For Gestational Age ◽

Predictive Value ◽

Perinatal Outcomes ◽

Adverse Perinatal Outcomes ◽

Umbilical Arteries

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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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Benefits of not smoking during pregnancy for Australian Aboriginal and Torres Strait Islander women and their babies: a retrospective cohort study using linked data

BMJ Open ◽

10.1136/bmjopen-2019-032763 ◽

2019 ◽

Vol 9 (11) ◽

pp. e032763 ◽

Cited By ~ 1

Author(s):

Carol McInerney ◽

Ibinabo Ibiebele ◽

Jane B Ford ◽

Deborah Randall ◽

Jonathan M Morris ◽

...

Keyword(s):

Preterm Birth ◽

Gestational Age ◽

Small For Gestational Age ◽

Lower Risk ◽

Perinatal Death ◽

Perinatal Outcomes ◽

Smoking During Pregnancy ◽

Relative Risks ◽

South Wales ◽

Adverse Perinatal Outcomes

ObjectivesTo provide evidence for targeted smoking cessation policy, the aim of this study was to compare pregnancy outcomes of Aboriginal mothers who reported not smoking during pregnancy with Aboriginal mothers who reported smoking during pregnancy.DesignPopulation based retrospective cohort study using linked data.SettingNew South Wales, the most populous Australian state.Population18 154 singleton babies born to 13 477 Aboriginal mothers between 2010 and 2014 were identified from routinely collected New South Wales datasets. Aboriginality was determined from birth records and from four linked datasets through an Enhanced Reporting of Aboriginality algorithm.ExposureNot smoking at any time during pregnancy.Main outcome measuresUnadjusted and adjusted relative risks (aRR) and 95% CIs from modified Poisson regression were used to examine associations between not smoking during pregnancy and maternal and perinatal outcomes including severe morbidity, inter-hospital transfer, perinatal death, preterm birth and small-for-gestational age. Population attributable fractions (PAFs) were calculated using adjusted relative risks.ResultsCompared with babies born to mothers who smoked during pregnancy, babies born to non-smoking mothers had a lower risk of all adverse perinatal outcomes including perinatal death (aRR=0.58, 95% CI 0.44 to 0.76), preterm birth (aRR=0.58, 95% CI 0.53 to 0.64) and small-for-gestational age (aRR=0.35, 95% CI 0.32 to 0.39). PAFs (%) were 27% for perinatal death, 26% for preterm birth and 48% for small-for-gestational-age. Compared with women who smoked during pregnancy (n=8919), those who did not smoke (n=9235) had a lower risk of being transferred to another hospital (aRR=0.76, 95% CI 0.66 to 0.89).ConclusionsBabies born to women who did not smoke during pregnancy had a lower risk of adverse perinatal outcomes. Rates of adverse outcomes among Aboriginal non-smokers were similar to those among the general population. These results quantify the proportion of adverse perinatal outcomes due to smoking and highlight why effective smoking cessation programme are urgently required for this population.

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OP13.03: Prediction of delivery of small-for-gestational age neonates and adverse perinatal outcomes by angiogenic factors at 37 weeks' gestation

Ultrasound in Obstetrics and Gynecology ◽

10.1002/uog.17812 ◽

2017 ◽

Vol 50 ◽

pp. 88-89

Author(s):

S. Triunfo ◽

A. Arranz ◽

V. Sureda-Rodriguez ◽

C. Dominguez ◽

E. Gratacós ◽

...

Keyword(s):

Gestational Age ◽

Small For Gestational Age ◽

Perinatal Outcomes ◽

Angiogenic Factors ◽

Adverse Perinatal Outcomes

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631Benefits of not smoking during pregnancy for Aboriginal women and their babies

International Journal of Epidemiology ◽

10.1093/ije/dyab168.664 ◽

2021 ◽

Vol 50 (Supplement_1) ◽

Author(s):

Siranda Torvaldsen ◽

Ibinabo Ibiebele ◽

Jane Ford ◽

Deborah Randall ◽

Jonathan Morris ◽

...

Keyword(s):

Preterm Birth ◽

Gestational Age ◽

Small For Gestational Age ◽

Lower Risk ◽

Perinatal Death ◽

Perinatal Outcomes ◽

Smoking During Pregnancy ◽

Relative Risks ◽

Aboriginal Women ◽

Adverse Perinatal Outcomes

Abstract Background To provide evidence for targeted smoking cessation policy, the aim of this study was to compare pregnancy outcomes of Aboriginal mothers who reported not smoking during pregnancy with those who reported smoking. Methods This population-based retrospective cohort study used linked data from routinely collected datasets. Not smoking during pregnancy was the exposure of interest among all New South Wales Aboriginal women who became mothers of singleton babies in 2010–2014. Unadjusted and adjusted relative risks (aRR) and 95%CIs from modified Poisson regression were used to examine associations between not smoking during pregnancy and maternal and perinatal outcomes including severe morbidity, inter-hospital transfer, perinatal death, preterm birth and small-for-gestational age. Population attributable fractions (PAFs) were calculated using adjusted relative risks. Results Compared with babies born to mothers who smoked during pregnancy, babies born to non-smoking mothers had a lower risk of all adverse perinatal outcomes including perinatal death (aRR=0.58, 95%CI 0.44–0.76), preterm birth (aRR=0.58, 95%CI 0.53–0.64) and small-for-gestational age (aRR=0.35, 95%CI 0.32–0.39). PAFs(%) were 27% for perinatal death, 26% for preterm birth and 48% for small-for-gestational-age. Compared with women who smoked during pregnancy (n = 8,919), those who did not smoke (n = 9,235) had a lower risk of being transferred to another hospital (aRR=0.76, 95%CI 0.66–0.89). Conclusions Babies born to women who did not smoke had much lower risks of all adverse perinatal outcomes. Key messages Between a quarter and a half of adverse perinatal outcomes in this population could potentially be prevented by an effective smoking cessation program.

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Demographic and Clinical Features of Small-for-Gestational-Age Infants Born to Mothers With Gestational Diabetes Mellitus

Frontiers in Pediatrics ◽

10.3389/fped.2021.741793 ◽

2021 ◽

Vol 9 ◽

Author(s):

Juncao Chen ◽

Huimin Xiao ◽

Yong Yang ◽

Yaping Tang ◽

Xiaoqi Yang ◽

...

Keyword(s):

Diabetes Mellitus ◽

Gestational Diabetes ◽

Gestational Diabetes Mellitus ◽

Gestational Age ◽

Small For Gestational Age ◽

Perinatal Outcomes ◽

First Year ◽

Retrospective Case ◽

Adverse Perinatal Outcomes ◽

First Year Of Life

We studied the demographic and clinical characteristic, risk factors, outcomes of full-term small-for-gestational-age (SGA) infants born to mothers with gestational diabetes mellitus (GDM) in China. A retrospective case-control study that included 1981 SGA infants was conducted; the demographic and clinical data between SGA infants born to mothers with and without GDM were compared. Of 383 SGA infants born to mothers with GDM, 221 (57.7%) were female, and the incidence of these infants was 1 in 155 live births. The risk of SGA siblings (RR, 1.88; 95% CI, [1.23–2.86]), low 1- and 5-min Apgar scores (RR,2.04 and 4.21; 95%CI [1.05–4.00] and [1.05–16.89], respectively), early thrombocytopenia (RR, 3.39; 95%CI, [1.33–8.64]), hypoglycemia(RR, 2.49; 95%CI, [1.55–3.98]), and hypoxic-ischemic encephalopathy (RR,5.61; 95%CI, [1.25–25.18]) were increased in SGA infants born to mothers with GDM compared to SGA infants born to mothers without GDM. SGA girls born to mothers with GDM had a significantly higher ratio of catch-up growth (CUG) (RR, 1.73; 95%CI, [1.18–2.54]) in the first year of life. These results show that genetic factors may be one of the etiologies of SGA infants born to mothers with GDM; and these infants have more adverse perinatal outcomes compared to SGA infants born to mothers without GDM. SGA girls born to mothers with GDM had accelerated CUG in the first year of life.

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