title: Predicting small for gestational age in the first trimester of pregnancy using maternal ophthalmic artery Doppler indices.
abstract: OBJECTIVE
  To assess the capacity of maternal ophthalmic Doppler indices for predicting small for gestational age (SGA) newborns in the first trimester of pregnancy.
  
  
  METHODS
  We performed a prospective observational cohort study involving 499 singleton pregnancies during the first trimester scan (11-14 weeks). The following maternal ophthalmic Doppler indices were assessed: pulsatility index (PI), first diastolic peak velocity (PD1) and peak ratio (PR) = PD1/peak systolic velocity. We considered SGA all newborns with weight below 10th percentile. We used chi-square test (χ(2)) to compare the groups. We used area under receiver operating characteristics (ROC) curves with 95% confidence intervals (CI) and detection rate of 5% of false positive of each maternal ophthalmic Doppler index and the mean uterine artery PI for prediction SGA.
  
  
  RESULTS
  27 (5.4%) patients delivered SGA newborns, 12 (2.4%) patients developed preeclampsia (PE) and delivered SGA newborns, and 460 had uneventful pregnancies (controls). We observed significant difference of PI and PR between SGA (SGA and SGA+PE) and control groups, p = 0.043 and p = 0.014, respectively. To 5% of false positive, the detection rate of SGA (SGA and SGA+PE groups) using PI, PD1 and PR were 14.8, 3.7, 14.8, 16.7, 16.7 and 16.7%, respectively. Mean uterine PI was significantly higher in the SGA+PE group (p = 0.003).
  
  
  CONCLUSIONS
  The isolated use of maternal ophthalmic Doppler indices or in combination with uterine artery Doppler, in the first trimester of pregnancy, was not efficient to predict SGA newborns.
authors.affiliation: a Department of Public Health , State University of Ceará (UECE) , Fortaleza - CE , Brazil .
authors.forename: Júlio Augusto
authors.initials: JA
authors.lastname: Gurgel Alves
authors.affiliation: a Department of Public Health , State University of Ceará (UECE) , Fortaleza - CE , Brazil .
authors.forename: Sammya Bezerra
authors.initials: SB
authors.lastname: Maia e Holanda Moura
authors.affiliation: b Department of Obstetrics , Paulista School of Medicine, Federal University of São Paulo (EPM-UNIFESP) , São Paulo - SP , Brazil .
authors.forename: Edward
authors.initials: E
authors.lastname: Araujo Júnior
authors.affiliation: c Department of Obstetrics and Gynecology , Guastalla Civil Hospital , ASL Reggio Emilia , Italy .
authors.forename: Gabriele
authors.initials: G
authors.lastname: Tonni
authors.affiliation: d Department of Obstetrics and Gynecology , Ribeirão Preto School of Medicine, University of São Paulo (DGO-FMRP-USP) , Ribeirão Preto - SP , Brazil , and.
authors.forename: Wellington P
authors.initials: WP
authors.lastname: Martins
authors.affiliation: e Ultrasound Services and Department of Perinatal Medicine , Royal Women's Hospital , Melbourne , VIC , Australia , and.|f Department of Obstetrics and Gynecology , University of Melbourne (UNIMELB) , Melbourne , VIC , Australia.
authors.forename: Fabrício
authors.initials: F
authors.lastname: Da Silva Costa
mesh_terms: D000328:Adult; D005260:Female; D005317:Fetal Growth Retardation / Q000175:diagnosis*; D006801:Humans; D007231:Infant, Newborn; D007236:Infant, Small for Gestational Age; D009035:Mothers; D009880:Ophthalmic Artery / Q000000981:diagnostic imaging*; D011237:Predictive Value of Tests; D011247:Pregnancy; D011261:Pregnancy Trimester, First; D011379:Prognosis; D011673:Pulsatile Flow; D018608:Ultrasonography, Doppler / Q000379:methods; D016216:Ultrasonography, Prenatal / Q000379:methods*; D055988:Uterine Artery / Q000000981:diagnostic imaging; D055815:Young Adult
keywords: First trimester; maternal ophthalmic Doppler; prediction; small for gestational age; uterine artery Doppler