Perinatology.  2020 Mar;31(1):14-19. 10.14734/PN.2020.31.1.14.

Cerebroplacental Ratio to Predict Adverse Perinatal Outcomes in Small-for-Gestational-Age Pregnancies

• Park J
• Ko M
• Kang BS
• Park J
• Ko HS
• Park IY

• KMID: 2507505
• DOI: http://doi.org/10.14734/PN.2020.31.1.14

Abstract

Objective
To evaluate the cerebroplacental ratio (CPR) to predict adverse perinatal outcomes in small-for-gestational-age (SGA) pregnancies.
Methods
The study was a retrospective study of cases of pregnant women with SGA babies delivered between 32 and 41 weeks' gestation, in Seoul St. Mary's Hospital between January 2009 and December 2015. We analyzed the neonatal adverse outcomes and the risk of emergency cesarean section due to non-reassuring fetal heart rate in pregnancies with norrnal CPR and abnormal CPR in Doppler ultrasonography.
Results
The abnormal CPR in SGA pregnancies was significantly associated with neonatal intensive care unit admission (P=0.042) and neonatal seizure (P=0.042), in multivariate logistic regression analysis. In receiver operating characteristic curves, the area under the curve (AUC) of abnormal CPR and severe SGA (less than 5th percentile) was 0.59, with sensitivity of 28.4% and specificity of 90.6% (P=0.038), in the emergency cesarean section due to non-reassuring fetal heart rate. However, between 32–36 weeks' gestation, AUC of abnormal CPR was 0.7 with sensitivity of 70.6% and specificity of 69.2% (P=0.019) and AUC of abnormal CPR and severe SGA was 0.77, with sensitivity of 64.7% and specificity of 84.6% (P=0.001), in the emergency cesarean section due to non-reassuring fetal heart rate.
Conclusion
When SGA is expected after 32 weeks' gestation, measurement of CPR might be useful in predicting neonatal adverse outcome. Abnormal CPR was highly predictive of cesarean section due to non-reassuring fetal heart rate, in severe SGA, between 32-36 weeks' gestation.

Keyword

Doppler; Infant; Small for gestational age; Pregnancy outcome