Doppler screening and predictors of adverse outcomes in high risk pregnancies affected by tobacco.
The purpose of this study was to investigate associations between Doppler measurements and adverse outcomes in an obstetric population with high tobacco use.



This retrospective study included patients with Doppler data (umbilical systolic/diastolic velocity ratios (S/D), uterine S/D, uterine left/right ratio index (RI)). Receiver operator characteristic curve analysis determined cut-off elevated Doppler indices. Stepwise logistic regression was used to predict adverse outcomes.



338 of 745 patients (45.4%) had adverse outcomes. Doppler artery indices identified significant associations with IUGR, preeclampsia, low birth weight, pre-term birth and composite adverse outcome variable. An elevated Umbilical S/D was 2.1 (95% Confidence Interval (CI): 1.5-2.9; p<0.001) times was more likely to have an adverse outcome. For left uterine artery S/D and nulliparity, the odds ratios were 1.8 (95% CI: 1.3-2.5) and 1.4 (95% CI: 1.0-1.9), respectively.



Umbilical and uterine left S/D indices and nulliparity are significant independent predictors of adverse outcomes.
Departmen of Obstetrics and Gynecology, West Virginia University - Charleston Division, Charleston Area Medical Center, 800 Pennsylvania Ave, Charleston, WV 25302, United States.
Alison
A
Stalzer
Center for Health Services and Outcomes Research, Charleston Area Medical Center Health Education and Research Institute, 3211 McCorkle Ave, SE, Charleston, WV 25304, United States.
Dara
D
Seybold
Center for Health Services and Outcomes Research, Charleston Area Medical Center Health Education and Research Institute, 3211 McCorkle Ave, SE, Charleston, WV 25304, United States.
Deena
D
Hossino
Center for Health Services and Outcomes Research, Charleston Area Medical Center Health Education and Research Institute, 3211 McCorkle Ave, SE, Charleston, WV 25304, United States.
Mike
M
Broce
Departmen of Obstetrics and Gynecology, West Virginia University - Charleston Division, Charleston Area Medical Center, 800 Pennsylvania Ave, Charleston, WV 25302, United States. Electronic address: Byron.calhoun@camc.org.
Byron
B
Calhoun
D005260:Female; D006801:Humans; D011237:Predictive Value of Tests; D011247:Pregnancy; D011248:Pregnancy Complications / Q000000981:diagnostic imaging / Q000209:etiology*; D011256:Pregnancy Outcome; D018566:Pregnancy, High-Risk; D012189:Retrospective Studies; D012907:Smoking / Q000009:adverse effects*; D018608:Ultrasonography, Doppler; D016216:Ultrasonography, Prenatal; D014469:Umbilical Arteries / Q000000981:diagnostic imaging*; D055988:Uterine Artery / Q000000981:diagnostic imaging*
Birth outcome; Doppler; Screening; Tobacco