Doppler predictors of adverse neonatal outcome in the growth restricted fetus at 34 weeks' gestation or beyond.
OBJECTIVE
The study was undertaken to assess whether prenatal Doppler variables can identify cases of fetal growth restriction (FGR) approaching term who are at risk for adverse neonatal outcome.


METHODS
From a cohort of FGR cases delivered at >or=34 weeks, fetal biometry and pulsatility indices (PI) of fetal arteries obtained less than 2 weeks before delivery were related to adverse neonatal outcome, defined as admission to the neonatal intensive care unit (NICU) for indications other than low birth weight alone.


RESULTS
Stepwise regression analysis showed that after controlling for gestational age at delivery and fetal biometry, only the last umbilical artery (UA) PI percentile was significantly predictive of adverse neonatal outcome (odds ratio=1.02, 95% CI 1.01-1.03, P=.02). Receiver operating characteristic curve analysis identified a UA PI at the 65th percentile as optimal predictor of adverse neonatal outcome (sensitivity=60%, false-positive rate=30%).


CONCLUSIONS
In FGR cases delivered at >/=34 weeks' gestation, Doppler PI at the UA independently predicts the likelihood of admission to the NICU for reasons other than low birth weight alone.
Department of Obstetrics and Gynecology, University of Milano-Bicocca, Monza, Italy.
Patrizia
P
Vergani
Camilla
C
Andreotti
Nadia
N
Roncaglia
Giulia
G
Zani
Elisa
E
Pozzi
John C
JC
Pezzullo
Alessandro
A
Ghidini
D001699:Biometry; D005260:Female; D005317:Fetal Growth Retardation / Q000150:complications*; D005333:Fetus / Q000033:anatomy & histology; D005865:Gestational Age; D006801:Humans; D007231:Infant, Newborn; D007232:Infant, Newborn, Diseases / Q000209:etiology*; D015931:Intensive Care, Neonatal; D017078:Laser-Doppler Flowmetry; D011247:Pregnancy; D011379:Prognosis; D011673:Pulsatile Flow; D014469:Umbilical Arteries / Q000502:physiology*