Second- to third-trimester longitudinal growth assessment for prediction of small-for-gestational age and late fetal growth restriction

Objective Detection of fetal growth restriction (FGR) remains poor and most screening strategies rely on cross-sectional evaluation of fetal size during the third trimester. A longitudinal and individualized approach has been proposed as an alternative method of evaluation. The aim of this study was...

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Autores: Caradeux J, Eixarch E, Mazarico E, Basuki TR, Gratacos E, Figueras F
Tipo de documento: artigo
Estado:Versão publicada
Data de publicação:2018
País:España
Recursos:Fundació Sant Joan de Déu
Repositório:r-FSJD. Repositorio Institucional de Producción Científica de la Fundació Sant Joan de Déu
OAI Identifier:oai:fsjd.fundanetsuite.com:p11056
Acesso em linha:https://fsjd.fundanetsuite.com/Publicaciones/ProdCientif/PublicacionFrw.aspx?id=11056
Access Level:Acceso aberto
Palavra-chave:fetal growth
fetal growth restriction
longitudinal growth
small-for-gestational age
ultrasound
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spelling Second- to third-trimester longitudinal growth assessment for prediction of small-for-gestational age and late fetal growth restrictionCaradeux JEixarch EMazarico EBasuki TRGratacos EFigueras Ffetal growthfetal growth restrictionlongitudinal growthsmall-for-gestational ageultrasoundObjective Detection of fetal growth restriction (FGR) remains poor and most screening strategies rely on cross-sectional evaluation of fetal size during the third trimester. A longitudinal and individualized approach has been proposed as an alternative method of evaluation. The aim of this study was to compare second- to third-trimester longitudinal growth assessment to cross-sectional evaluation in the third trimester for the prediction of small-for-gestational age (SGA) and late FGR in low-risk singleton pregnancy. Methods This was a prospective cohort study of 2696 unselected consecutive low-risk singleton pregnancies scanned at 21 +/- 2 and 32 +/- 2 weeks. For cross-sectional growth assessment, abdominal circumference (AC) measurements were transformed to z-values according the 21st-INTERGROWTH standards. Longitudinal growth assessment was performed by calculating the AC z-velocity and the second-to third-trimester AC conditional growth centile. Longitudinal assessment was compared with cross-sectional assessment at 32 weeks. Association of cross-sectional and longitudinal evaluations with SGA and late FGR was assessed by logistic regression analysis. Predictive performance was determined by receiver-operating characteristics curve analysis. Result In total, 210 (7.8%) newborns were classified as SGA and 103 (3.8%) as late FGR. Neither longitudinal measurement improved the association with SGA or late FGR provided by cross-sectional evaluation of AC z-score at 32 weeks. Areas under the curves of AC z-velocity and conditional AC growth were significantly smaller than those of cross-sectional AC z-scores (P < 0.001), although AC z-velocity performed significantly better than did conditional AC growth (P < 0.001). Conclusion Longitudinal assessment of fetal growth from the second to third trimester has a low predictive capacity for SGA and late FGR in low-risk singleton pregnancy compared with cross-sectional growth evaluation. Copyright (C) 2017 ISUOG. Published by John Wiley & Sons Ltd.WILEY2018info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionhttps://fsjd.fundanetsuite.com/Publicaciones/ProdCientif/PublicacionFrw.aspx?id=11056ULTRASOUND IN OBSTETRICS & GYNECOLOGYISSN: 09607692ISSNe: 14690705reponame:r-FSJD. Repositorio Institucional de Producción Científica de la Fundació Sant Joan de Déuinstname:Fundació Sant Joan de DéuInglésinfo:eu-repo/semantics/openAccessoai:fsjd.fundanetsuite.com:p110562026-05-27T12:37:41Z
dc.title.none.fl_str_mv Second- to third-trimester longitudinal growth assessment for prediction of small-for-gestational age and late fetal growth restriction
title Second- to third-trimester longitudinal growth assessment for prediction of small-for-gestational age and late fetal growth restriction
spellingShingle Second- to third-trimester longitudinal growth assessment for prediction of small-for-gestational age and late fetal growth restriction
Caradeux J
fetal growth
fetal growth restriction
longitudinal growth
small-for-gestational age
ultrasound
title_short Second- to third-trimester longitudinal growth assessment for prediction of small-for-gestational age and late fetal growth restriction
title_full Second- to third-trimester longitudinal growth assessment for prediction of small-for-gestational age and late fetal growth restriction
title_fullStr Second- to third-trimester longitudinal growth assessment for prediction of small-for-gestational age and late fetal growth restriction
title_full_unstemmed Second- to third-trimester longitudinal growth assessment for prediction of small-for-gestational age and late fetal growth restriction
title_sort Second- to third-trimester longitudinal growth assessment for prediction of small-for-gestational age and late fetal growth restriction
dc.creator.none.fl_str_mv Caradeux J
Eixarch E
Mazarico E
Basuki TR
Gratacos E
Figueras F
author Caradeux J
author_facet Caradeux J
Eixarch E
Mazarico E
Basuki TR
Gratacos E
Figueras F
author_role author
author2 Eixarch E
Mazarico E
Basuki TR
Gratacos E
Figueras F
author2_role author
author
author
author
author
dc.subject.none.fl_str_mv fetal growth
fetal growth restriction
longitudinal growth
small-for-gestational age
ultrasound
topic fetal growth
fetal growth restriction
longitudinal growth
small-for-gestational age
ultrasound
description Objective Detection of fetal growth restriction (FGR) remains poor and most screening strategies rely on cross-sectional evaluation of fetal size during the third trimester. A longitudinal and individualized approach has been proposed as an alternative method of evaluation. The aim of this study was to compare second- to third-trimester longitudinal growth assessment to cross-sectional evaluation in the third trimester for the prediction of small-for-gestational age (SGA) and late FGR in low-risk singleton pregnancy. Methods This was a prospective cohort study of 2696 unselected consecutive low-risk singleton pregnancies scanned at 21 +/- 2 and 32 +/- 2 weeks. For cross-sectional growth assessment, abdominal circumference (AC) measurements were transformed to z-values according the 21st-INTERGROWTH standards. Longitudinal growth assessment was performed by calculating the AC z-velocity and the second-to third-trimester AC conditional growth centile. Longitudinal assessment was compared with cross-sectional assessment at 32 weeks. Association of cross-sectional and longitudinal evaluations with SGA and late FGR was assessed by logistic regression analysis. Predictive performance was determined by receiver-operating characteristics curve analysis. Result In total, 210 (7.8%) newborns were classified as SGA and 103 (3.8%) as late FGR. Neither longitudinal measurement improved the association with SGA or late FGR provided by cross-sectional evaluation of AC z-score at 32 weeks. Areas under the curves of AC z-velocity and conditional AC growth were significantly smaller than those of cross-sectional AC z-scores (P < 0.001), although AC z-velocity performed significantly better than did conditional AC growth (P < 0.001). Conclusion Longitudinal assessment of fetal growth from the second to third trimester has a low predictive capacity for SGA and late FGR in low-risk singleton pregnancy compared with cross-sectional growth evaluation. Copyright (C) 2017 ISUOG. Published by John Wiley & Sons Ltd.
publishDate 2018
dc.date.none.fl_str_mv 2018
dc.type.none.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
format article
status_str publishedVersion
dc.identifier.none.fl_str_mv https://fsjd.fundanetsuite.com/Publicaciones/ProdCientif/PublicacionFrw.aspx?id=11056
url https://fsjd.fundanetsuite.com/Publicaciones/ProdCientif/PublicacionFrw.aspx?id=11056
dc.language.none.fl_str_mv Inglés
language_invalid_str_mv Inglés
dc.rights.none.fl_str_mv info:eu-repo/semantics/openAccess
eu_rights_str_mv openAccess
dc.publisher.none.fl_str_mv WILEY
publisher.none.fl_str_mv WILEY
dc.source.none.fl_str_mv ULTRASOUND IN OBSTETRICS & GYNECOLOGY
ISSN: 09607692
ISSNe: 14690705
reponame:r-FSJD. Repositorio Institucional de Producción Científica de la Fundació Sant Joan de Déu
instname:Fundació Sant Joan de Déu
instname_str Fundació Sant Joan de Déu
reponame_str r-FSJD. Repositorio Institucional de Producción Científica de la Fundació Sant Joan de Déu
collection r-FSJD. Repositorio Institucional de Producción Científica de la Fundació Sant Joan de Déu
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