Predictiveness of antenatal umbilical artery Doppler for adverse pregnancy outcome in small-for-gestational-age babies according to customised birthweight centiles: population-based study.
OBJECTIVE
To examine the relationship between smallness at birth and the predictive value of umbilical artery Doppler.


METHODS
Retrospective cohort.


METHODS
Tertiary referral university hospital, Barcelona.


METHODS
A total of 7645 singleton pregnancies delivered between January 2002 and June 2004.


METHODS
The associations with adverse outcome were assessed for small-for-gestational-age (SGA) babies according to customised standards who had normal and abnormal umbilical artery Doppler.


METHODS
Neonatal morbidity and perinatal mortality.


RESULTS
Of the 369 SGA fetuses that had been identified antenatally, 70 (19%) had an abnormal umbilical artery Doppler and the babies from these pregnancies had a higher risk for neonatal morbidity when compared with babies with normal birthweight (OR 3.99, 95% CI 1.04-11.03). However, the remaining 299 (81%) fetuses with normal umbilical artery Doppler also had an elevated risk of neonatal morbidity (OR 2.26, 95% CI 1.04-4.39). Overall, many of the instances of adverse outcome associated with smallness for gestational age were attributable to the group with normal Doppler than to the group with abnormal Doppler.


CONCLUSIONS
Normal antenatal umbilical artery Doppler cannot be taken as an indicator of low risk in pregnancies where the fetus is SGA according to customised percentiles.
Figueras
F
F
Department of Obstetrics, Hospital Clinic, Barcelona, Spain. ffiguera@clinic.ub.es
Eixarch
E
E
Gratacos
E
E
Gardosi
J
J
D000328:Adult; D001724:Birth Weight; D001783:Blood Flow Velocity / Q000502:physiology; D015331:Cohort Studies; D042241:Early Diagnosis; D005260:Female; D005317:Fetal Growth Retardation / Q000000981:diagnostic imaging* / Q000503:physiopathology; D006801:Humans; D007231:Infant, Newborn; D007236:Infant, Small for Gestational Age; D011237:Predictive Value of Tests; D011247:Pregnancy; D011256:Pregnancy Outcome; D012189:Retrospective Studies; D018570:Risk Assessment; D018608:Ultrasonography, Doppler / Q000592:standards*; D016216:Ultrasonography, Prenatal / Q000592:standards*; D014469:Umbilical Arteries / Q000000981:diagnostic imaging / Q000502:physiology*