Longitudinal change in cerebro-placental ratio (CPR) between 37 and 40 weeks of pregnancy is associated with non-reassuring fetal status and increased risk of cesarean section
OBJECTIVE: To evaluate in low-risk pregnancies if longitudinal change in cerebro-placental ratio (CPR) between 37 and 40 weeks of pregnancy is associated with cesarean section (CS) for non-reassuring fetal status (NRFS) during labor.
METHODS: This is a prospective observational study of women with singleton low-risk pregnancies who underwent an ultrasound scan at 36 + 0 to 37 + 6 and 39 + 0 to 41 + 6 weeks of pregnancy, when the CPR was calculated from the middle cerebral artery (MCA) and umbilical artery (UA) pulsatility indices. Managing professionals were kept blinded to the Doppler results. The association of the longitudinal change between both CPR (z-velocity) to CS for NRFS was evaluated by logistic regression.
RESULTS: A total of 401 pregnancies were included. The mean time interval between both CPR evaluations was 21 days (SD 7). A CS for fetal distress was performed in 7% of pregnancies. Independent of the CPR at 37 weeks, the likelihood of CS for fetal distress was significantly decreased by the longitudinal changes from 37 to 40 weeks (OR 0.61, 95%CI 0.4-0.92; p=.018). This association remained significant after further adjustment for potential confounders (nulliparity, maternal weight at booking and estimated fetal weight at 37): (OR 0.64, 95%CI 0.41-0.98; p=.044).
CONCLUSIONS: The longitudinal change of CPR between 37 and 40 weeks is associated with the need for CS for NRFS during labor.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2023 |
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| Erschienen: |
2023 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:36 |
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| Enthalten in: |
The journal of maternal-fetal & neonatal medicine : the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians - 36(2023), 1 vom: 25. Dez., Seite 2191776 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Cancemi, Annalisa [VerfasserIn] |
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| Links: |
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| Themen: |
Cerebro-placental ratio |
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| Anmerkungen: |
Date Completed 24.03.2023 Date Revised 24.03.2023 published: Print Citation Status MEDLINE |
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| doi: |
10.1080/14767058.2023.2191776 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM354534343 |
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| 100 | 1 | |a Cancemi, Annalisa |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Longitudinal change in cerebro-placental ratio (CPR) between 37 and 40 weeks of pregnancy is associated with non-reassuring fetal status and increased risk of cesarean section |
| 264 | 1 | |c 2023 | |
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| 500 | |a Date Revised 24.03.2023 | ||
| 500 | |a published: Print | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a OBJECTIVE: To evaluate in low-risk pregnancies if longitudinal change in cerebro-placental ratio (CPR) between 37 and 40 weeks of pregnancy is associated with cesarean section (CS) for non-reassuring fetal status (NRFS) during labor | ||
| 520 | |a METHODS: This is a prospective observational study of women with singleton low-risk pregnancies who underwent an ultrasound scan at 36 + 0 to 37 + 6 and 39 + 0 to 41 + 6 weeks of pregnancy, when the CPR was calculated from the middle cerebral artery (MCA) and umbilical artery (UA) pulsatility indices. Managing professionals were kept blinded to the Doppler results. The association of the longitudinal change between both CPR (z-velocity) to CS for NRFS was evaluated by logistic regression | ||
| 520 | |a RESULTS: A total of 401 pregnancies were included. The mean time interval between both CPR evaluations was 21 days (SD 7). A CS for fetal distress was performed in 7% of pregnancies. Independent of the CPR at 37 weeks, the likelihood of CS for fetal distress was significantly decreased by the longitudinal changes from 37 to 40 weeks (OR 0.61, 95%CI 0.4-0.92; p=.018). This association remained significant after further adjustment for potential confounders (nulliparity, maternal weight at booking and estimated fetal weight at 37): (OR 0.64, 95%CI 0.41-0.98; p=.044) | ||
| 520 | |a CONCLUSIONS: The longitudinal change of CPR between 37 and 40 weeks is associated with the need for CS for NRFS during labor | ||
| 650 | 4 | |a Observational Study | |
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Cesarean-section | |
| 650 | 4 | |a cerebro-placental ratio | |
| 650 | 4 | |a fetal distress | |
| 650 | 4 | |a longitudinal Doppler | |
| 650 | 4 | |a singleton low-risk pregnancies | |
| 700 | 1 | |a Rial-Crestelo, Marta |e verfasserin |4 aut | |
| 700 | 1 | |a Martinez, Judit |e verfasserin |4 aut | |
| 700 | 1 | |a Giannone, Mariella |e verfasserin |4 aut | |
| 700 | 1 | |a Sánchez-Hoyo, Beatriz |e verfasserin |4 aut | |
| 700 | 1 | |a Izquierdo-Sánchez, Nora |e verfasserin |4 aut | |
| 700 | 1 | |a Cobos-Serrano, Cristina |e verfasserin |4 aut | |
| 700 | 1 | |a Matías-Ponce, Sonia |e verfasserin |4 aut | |
| 700 | 1 | |a Mayordomo-Gallardo, Sonia |e verfasserin |4 aut | |
| 700 | 1 | |a Hansson, Stefan R |e verfasserin |4 aut | |
| 700 | 1 | |a Figueras, Francesc |e verfasserin |4 aut | |
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