Objective: To assess the association of the umbilicocerebral ratio (UCR) with adverse perinatal outcome in late preterm small-for-gestational age (SGA) fetuses and to investigate the effect on perinatal outcomes of immediate delivery.
Design: Multicentre cohort study with nested randomised controlled trial (RCT).
Setting: Nineteen secondary and tertiary care centres.
Population: Singleton SGA pregnancies (estimated fetal weight [EFW] or fetal abdominal circumference [FAC] <10th centile) from 32 to 36 weeks.
Methods: Women were classified: (1) RCT-eligible: abnormal UCR twice consecutive and EFW below the 3 centile at/or below 35 weeks or below the 10 centile at 36 weeks; (2) abnormal UCR once or intermittent; (3) never abnormal UCR. Consenting RCT-eligible patients were randomised for immediate delivery from 34 weeks or expectant management until 37 weeks.
Main Outcome Measures: A composite adverse perinatal outcome (CAPO), defined as perinatal death, birth asphyxia or major neonatal morbidity.
Results: The cohort consisted of 690 women. The study was halted prematurely for low RCT-inclusion rates (n = 40). In the RCT-eligible group, gestational age at delivery, birthweight and birthweight multiple of the median (MoM) (0.66, 95% confidence interval [CI] 0.59-0.72) were significantly lower and the CAPO (n = 50, 44%, p < 0.05) was more frequent. Among patients randomised for immediate delivery there was a near-significant lower birthweight (p = 0.05) and higher CAPO (p = 0.07). EFW MoM, pre-eclampsia, gestational hypertension and Doppler classification were independently associated with the CAPO (area under the curve 0.71, 95% CI 0.67-0.76).
Conclusions: Perinatal risk was effectively identified by low EFW MoM and UCR. Early delivery of SGA fetuses with an abnormal UCR at 34-36 weeks should only be performed in the context of clinical trials.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1111/1471-0528.17770 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Associations between vaping during pregnancy and perinatal outcomes: A systematic review and meta-analysis.
J Hazard Mater
December 2024
Alberta Respiratory Centre, Division of Pulmonary Medicine, Department of Medicine, University of Alberta, Edmonton, Alberta, Canada; Bagchi School of Public Health, Ahmedabad University, Ahmedabad, India. Electronic address:
Despite numerous studies linking prenatal vaping to adverse perinatal outcomes, a systematic assessment for critical comparison remains absent. To investigate these associations, we conducted a systematic search of studies assessing perinatal outcomes in mothers and/or neonates exposed to vaping during pregnancy compared to those in women without prenatal vaping exposure through MEDLINE, EMBASE, Scopus, Web of Science, Cochrane Library, PROSPERO, and Google Scholar until July 5, 2024. We performed inverse-variance random-effects meta-analyses for maternal and neonatal outcomes of 23 studies with a total of 924,376 participants with 7552 reporting vaping-only use during pregnancy.
View Article and Find Full Text PDFAflatoxin B and fumonisin B exposure and adverse birth outcomes in HIV-infected and HIV-uninfected women from Harare, Zimbabwe.
Drug Chem Toxicol
January 2025
Immunology Unit, Department of Laboratory, Diagnostic and Investigative Sciences, Faculty of Medicine and Health Sciences, University of Zimbabwe, Harare, Zimbabwe.
Aflatoxin B (AFB1) and fumonisin B (FB1) are toxic secondary products of fungi that frequently contaminate staple crops in resource-limited settings. Antenatal AFB1 and FB1 exposure may cause adverse birth outcomes. We conducted a retrospective substudy nested in a case-control cohort of HIV-infected and HIV-uninfected women ≥20 weeks gestation from Harare, Zimbabwe.
View Article and Find Full Text PDFInter-pregnancy interval and associated factors among parous women in neighboring low-land ecologies of arsi & east shoa zone, southeast Ethiopia: a community-based cross-sectional study.
Contracept Reprod Med
January 2025
Department of Health Sciences, Global Health Unit, University Medical Center Groningen, Groningen, The Netherlands.
Background: The World Health Organization (WHO) recommends an interval of at least 24 months from the date of a live birth to the conception of the next pregnancy in order to reduce the risk of adverse maternal, perinatal, and infant outcomes. There is limited data about the implementation of this recommendation and its contributing factors in low-land ecologies in Oromia, which is the biggest regional state in Ethiopia.
Objective: To assess the inter-pregnancy interval and determine associated factors among parous women in selected low-land districts of Arsi and East Shoa Zone.
Using routine data to examine factors associated with stillbirth in three tertiary maternity facilities in Kabul, Afghanistan.
Reprod Health
January 2025
Department of Public Health, Institute of Tropical Medicine, Antwerp, Belgium.
Background: Over one-third of the global stillbirth burden occurs in countries affected by conflict or a humanitarian crisis, including Afghanistan. Stillbirth rates in Afghanistan remained high in 2021 at over 26 per 1000 births. Stillbirths have devastating physical, psycho-social and economic impacts on women, families and healthcare providers.
View Article and Find Full Text PDFChildbirth after cancer among 42,896 male adolescents and young adults: a population-based study.
J Natl Cancer Inst
January 2025
UT Southwestern O'Donnell School of Public Health, Dallas, TX, USA.
Background: Few studies have examined childbirth and adverse perinatal outcomes among male adolescents and young adults with cancer (AYAs, diagnosed at age 15-39 years). We conducted a population-based assessment of these outcomes in a large, diverse sample.
Methods: Male AYAs diagnosed between January 1, 1995 and December 31, 2015 were identified using the Texas Cancer Registry and linked to live birth certificates and the Texas Birth Defects Registry through December 31, 2016.
Want AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!