Prediction of late-onset fetal growth restriction by umbilical artery
velocities at 37 weeks' gestation
Abstract
Objectives: To explore the predictive capacity of the umbilical artery
velocities at 37 weeks’ gestation in identifying fetal growth
restriction (FGR), small-for-gestational-age (SGA) neonates and adverse
perinatal outcome (APO). Methods: We retrospectively recruited FGR and
SGA with normal umbilical artery Doppler at 37 weeks, and
adequate-for-gestational age (AGA) controls in a tertiary referral
center. All the parameters of the umbilical artery velocities were
measured at about 37 weeks’ gestation, including the umbilical artery
end-diastolic velocity (UA-EDV), umbilical artery peak systolic velocity
(UA-PSV), umbilical artery mean diastolic velocity (UA-MDV) and
umbilical artery time-averaged maximum velocity (UA-TAMXV). Results: A
total of 569 cases were included in the study and divided into three
groups: FGR group, SGA group and AGA group. Of these, 39 (6.9%) were
identified as FGR, 57 (10.0%) were SGA and 473 (83.1%) were AGA. Among
the three groups, the UA-MDV, UA-TAMXV, UA-PSV, and UA-EDV were
decreased with the severity of growth restriction. Multivariate logistic
regression analyses showed that the UA-TAMXV was independent predicting
factor of FGR. It had a moderate predictive value for FGR, with an area
under the ROC curve of 0.821 [95% confidence interval (CI):
0.785-0.853]. Conclusions: The UA velocities were decreased with the
severity of growth restriction and the UA-TAMXV was independently
predictive of FGR. The results suggest that UA-TAMXV might be a new
parameter to predict FGR.