Risk stratification for early-onset fetal growth restriction in women with abnormal serum biomarkers: a retrospective cohort study

Abstract Abnormal maternal serum biomarkers (AMSB), identified through the aneuploidy screening programme, are frequent incidental findings in pregnancy. They are associated with fetal growth restriction (FGR), but previous studies have not examined whether this association is with early-onset (<...

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Autores principales:	L. Ormesher, L. Warrander, Y. Liu, S. Thomas, L. Simcox, G. C. S. Smith, J. E. Myers, E. D. Johnstone
Formato:	article
Lenguaje:	EN
Publicado:	Nature Portfolio 2020
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/44e3d63be3224d5aa0a7a0b6bdae4348
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spelling	oai:doaj.org-article:44e3d63be3224d5aa0a7a0b6bdae43482021-12-02T12:42:17ZRisk stratification for early-onset fetal growth restriction in women with abnormal serum biomarkers: a retrospective cohort study10.1038/s41598-020-78631-52045-2322https://doaj.org/article/44e3d63be3224d5aa0a7a0b6bdae43482020-12-01T00:00:00Zhttps://doi.org/10.1038/s41598-020-78631-5https://doaj.org/toc/2045-2322Abstract Abnormal maternal serum biomarkers (AMSB), identified through the aneuploidy screening programme, are frequent incidental findings in pregnancy. They are associated with fetal growth restriction (FGR), but previous studies have not examined whether this association is with early-onset (< 34 weeks) or late-onset (> 34 weeks) FGR; as a result there is no consensus on management. The aims of this study were to determine the prevalence and phenotype of FGR in women with AMSB and test the predictive value of placental sonographic screening to predict early-onset FGR. 1196 pregnant women with AMSB underwent a 21–24 week “placental screen” comprising fetal and placental size, and uterine artery Doppler. Multivariable regression was used to calculate a predictive model for early-onset FGR (birthweight centile < 3rd/< 10th with absent umbilical end-diastolic flow, < 34 weeks). FGR prevalence was high (10.3%), however early-onset FGR was uncommon (2.3%). Placental screening effectively identified early-onset (area under the curve (AUC) 0.93, 95% confidence interval (CI) 0.87–1.00), but not late-onset FGR (AUC 0.70, 95% CI 0.64–0.75). Internal validation demonstrated robust performance for detection/exclusion of early-onset FGR. In this cohort, utilisation of our proposed algorithm with targeted fetal growth and Doppler surveillance, compared with universal comprehensive surveillance would have avoided 1044 scans, potentiating significant cost-saving for maternity services.L. OrmesherL. WarranderY. LiuS. ThomasL. SimcoxG. C. S. SmithJ. E. MyersE. D. JohnstoneNature PortfolioarticleMedicineRScienceQENScientific Reports, Vol 10, Iss 1, Pp 1-11 (2020)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q L. Ormesher L. Warrander Y. Liu S. Thomas L. Simcox G. C. S. Smith J. E. Myers E. D. Johnstone Risk stratification for early-onset fetal growth restriction in women with abnormal serum biomarkers: a retrospective cohort study
description	Abstract Abnormal maternal serum biomarkers (AMSB), identified through the aneuploidy screening programme, are frequent incidental findings in pregnancy. They are associated with fetal growth restriction (FGR), but previous studies have not examined whether this association is with early-onset (< 34 weeks) or late-onset (> 34 weeks) FGR; as a result there is no consensus on management. The aims of this study were to determine the prevalence and phenotype of FGR in women with AMSB and test the predictive value of placental sonographic screening to predict early-onset FGR. 1196 pregnant women with AMSB underwent a 21–24 week “placental screen” comprising fetal and placental size, and uterine artery Doppler. Multivariable regression was used to calculate a predictive model for early-onset FGR (birthweight centile < 3rd/< 10th with absent umbilical end-diastolic flow, < 34 weeks). FGR prevalence was high (10.3%), however early-onset FGR was uncommon (2.3%). Placental screening effectively identified early-onset (area under the curve (AUC) 0.93, 95% confidence interval (CI) 0.87–1.00), but not late-onset FGR (AUC 0.70, 95% CI 0.64–0.75). Internal validation demonstrated robust performance for detection/exclusion of early-onset FGR. In this cohort, utilisation of our proposed algorithm with targeted fetal growth and Doppler surveillance, compared with universal comprehensive surveillance would have avoided 1044 scans, potentiating significant cost-saving for maternity services.
format	article
author	L. Ormesher L. Warrander Y. Liu S. Thomas L. Simcox G. C. S. Smith J. E. Myers E. D. Johnstone
author_facet	L. Ormesher L. Warrander Y. Liu S. Thomas L. Simcox G. C. S. Smith J. E. Myers E. D. Johnstone
author_sort	L. Ormesher
title	Risk stratification for early-onset fetal growth restriction in women with abnormal serum biomarkers: a retrospective cohort study
title_short	Risk stratification for early-onset fetal growth restriction in women with abnormal serum biomarkers: a retrospective cohort study
title_full	Risk stratification for early-onset fetal growth restriction in women with abnormal serum biomarkers: a retrospective cohort study
title_fullStr	Risk stratification for early-onset fetal growth restriction in women with abnormal serum biomarkers: a retrospective cohort study
title_full_unstemmed	Risk stratification for early-onset fetal growth restriction in women with abnormal serum biomarkers: a retrospective cohort study
title_sort	risk stratification for early-onset fetal growth restriction in women with abnormal serum biomarkers: a retrospective cohort study
publisher	Nature Portfolio
publishDate	2020
url	https://doaj.org/article/44e3d63be3224d5aa0a7a0b6bdae4348
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Risk stratification for early-onset fetal growth restriction in women with abnormal serum biomarkers: a retrospective cohort study

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