Differential performance of first-trimester screening in predicting small-for-gestational-age neonate or fetal growth restriction

F. Crovetto, S. Triunfo, F. Crispi, V. Rodriguez-Sureda, C. Dominguez, F. Figueras, E. Gratacos

Research output: Contribution to journalArticlepeer-review

Abstract

Objective: To assess the ability of integrated first-trimester screening, combining maternal characteristics and biophysical and biochemical markers, to predict delivery of a small-for-gestational-age (SGA) neonate, and compare this with its ability to predict fetal growth restriction (FGR). Methods: This was a prospective cohort study of singleton pregnancies undergoing routine first-trimester screening. SGA was defined as birth weight (BW) < 10th percentile and FGR was defined as an ultrasound estimated fetal weight < 10th percentile plus Doppler abnormalities, or BW < 3rd percentile. Logistic regression-based predictive models were developed for predicting SGA and FGR. Models incorporated the a-priori risk from maternal characteristics, and mean arterial pressure, uterine artery Doppler, placental growth factor and soluble fms-like tyrosine kinase-1. Results: In total, 9150 births were included. Of these, 979 (10.7%) qualified for a postnatal diagnosis of SGA and 462 (5.0%) for a prenatal diagnosis of FGR. For predicting SGA, the model achieved a detection rate of 35% for a false-positive rate (FPR) of 5% and 42% for a 10% FPR. The model's performance was significantly higher for predicting FGR (P < 0.001), with detection rates of 59% and 67%, for a FPR of 5% and 10%, respectively. Conclusion: The predictive performance of first-trimester screening for cases with growth impairment by a combination of maternal characteristics and biophysical and biochemical markers is improved significantly when a prenatal and strict definition of FGR is used rather than a postnatal definition based on BW.

Original languageEnglish
Pages (from-to)349-356
Number of pages8
JournalUltrasound in Obstetrics and Gynecology
Volume49
Issue number3
DOIs
Publication statusPublished - Mar 1 2017
Externally publishedYes

Keywords

  • fetal growth restriction
  • first-trimester screening
  • placental growth factor
  • small-for-gestational age
  • soluble fms-like tyrosine kinase-1

ASJC Scopus subject areas

  • Radiological and Ultrasound Technology
  • Reproductive Medicine
  • Radiology Nuclear Medicine and imaging
  • Obstetrics and Gynaecology

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