Nuchal translucency thickness in euploid fetuses: is two millimeters too risky?
We sought to determine whether nuchal translucency (NT) thickness of >or= 2 mm poses a risk for adverse perinatal outcome. A prospective observational study was conducted including all singleton pregnancies undergoing NT screening between 11 and 13.6 weeks' gestation, from January 1999 to October 2006, in a University Medical Center. Aneuploid and malformed fetuses were excluded from the analysis, as well as fetuses from pregnancies that ended before 22 gestational weeks. A comparison was performed between fetuses with NT of >or= 2 mm and those with NT < 2 mm. Stratified analyses using the Mantel-Haenszel technique and multivariable analyses were performed to control for confounders. A total of 2205 singleton fetuses with normal karyotype were evaluated during the study period. Of these, 2.0% ( N = 45) had NT of 2 mm and above. Pregnancies with NT of >or= 2 mm were significantly associated with diabetes mellitus (either gestational or pregestational; odds ratio [OR] = 2.3, 95% confidence interval [CI] 1.02 to 5.1; P = 0.023). Higher rates of perinatal mortality (OR = 17.5, 95% CI 4.5 to 61.8; P < 0.001) and stillbirth in particular (OR = 25.6, 95% CI 4.9 to 120.7; P < 0.001) were noted among pregnancies with NT >or= 2 mm. Using a multivariable analysis and controlling for confounders such as diabetes mellitus and the crown-rump length, NT >or= 2 mm was found to be an independent risk factor for perinatal mortality (adjusted OR 14.3; 95% CI 1.8 to 3.5; P < 0.001). Nuchal translucency thickness of >or= 2 mm in euploid, anatomically normal fetuses poses a significant risk for adverse perinatal outcome.
Fink
Miriam
M
Division of Obstetrics and Gynecology, Soroka University Medical Center, Ben-Gurion University of the Negev, Beer-Sheva, Israel.
Sheiner
Eyal
E
Sheizaf
Boaz
B
Hershkovitz
Reli
R
Bashiri
Asher
A
Mazor
Moshe
M
Wiznitzer
Arnon
A
D000328:Adult; D015331:Cohort Studies; D016001:Confidence Intervals; D000013:Congenital Abnormalities / Q000175:diagnosis* / Q000453:epidemiology; D018568:Crown-Rump Length; D005260:Female; D047109:Fetal Development / Q000502:physiology; D005500:Follow-Up Studies; D005865:Gestational Age; D006801:Humans; D007231:Infant, Newborn; D007232:Infant, Newborn, Diseases / Q000175:diagnosis / Q000453:epidemiology; D008423:Maternal Age; D015999:Multivariate Analysis; D048208:Nuchal Translucency Measurement; D016017:Odds Ratio; D010298:Parity; D054238:Perinatal Mortality / Q000639:trends*; D011247:Pregnancy; D011256:Pregnancy Outcome; D011295:Prenatal Care / Q000379:methods; D011336:Probability; D011446:Prospective Studies; D018570:Risk Assessment; D012680:Sensitivity and Specificity; D016216:Ultrasonography, Prenatal