Relationship between abnormal fetal testing and adverse perinatal outcomes in intrauterine growth restriction

Juan M. Gonzalez, David M. Stamilio, Serdar Ural, George A. Macones, Anthony O. Odibo

Research output: Contribution to journalArticle

25 Citations (Scopus)

Abstract

Objective: This study was undertaken to compare the efficacy of nonstress test, biophysical profile, or abnormal Dopplers in predicting adverse perinatal outcomes in intrauterine growth restriction. Study Design: Retrospective cohort study of intrauterine growth restriction (birthweight < fifth percentile for gestation) over a 7-year period. We excluded twins or fetuses with aneuploidy or congenital malformations. Abnormal antenatal testing were defined as: nonstress test that was nonreactive or with significant decelerations, biophysical profile less than or equal to 6, and abnormal Doppler as umbilical artery with absent or reversed end diastolic flow. The outcomes studied included: umbilical artery pH less than 7, respiratory distress syndrome, periventricular leukomalacia, grades 3-4 intraventricular hemorrhage, perinatal mortality, necrotizing enterocolitis, and a composite of at least 1 adverse outcome. Statistical analysis included bivariate and multivariable techniques. Results: We identified 151 singleton pregnancies with intrauterine growth restriction meeting the inclusion criteria. On bivariate analysis significant variables associated with adverse outcomes were as follows: history of chronic hypertension, corticosteroid administration, and gestational age of delivery. These were adjusted by using logistic regression. The positive predictive values of abnormal Doppler for respiratory distress syndrome and the composite of adverse outcomes were 36% and 42% respectively. Of the testing modalities compared, only abnormal Doppler significantly predicted respiratory distress syndrome and the composite of adverse outcome. Conclusion: In cases of intrauterine growth restriction, the presence of abnormal Doppler is the best predictor of adverse perinatal outcome.

Original languageEnglish (US)
JournalAmerican journal of obstetrics and gynecology
Volume196
Issue number5
DOIs
StatePublished - May 1 2007

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Umbilical Arteries
Growth
Periventricular Leukomalacia
Pregnancy
Necrotizing Enterocolitis
Deceleration
Perinatal Mortality
Aneuploidy
Gestational Age
Adrenal Cortex Hormones
Fetus
Cohort Studies
Retrospective Studies
Logistic Models
Hemorrhage
Hypertension

All Science Journal Classification (ASJC) codes

  • Obstetrics and Gynecology

Cite this

Gonzalez, Juan M. ; Stamilio, David M. ; Ural, Serdar ; Macones, George A. ; Odibo, Anthony O. / Relationship between abnormal fetal testing and adverse perinatal outcomes in intrauterine growth restriction. In: American journal of obstetrics and gynecology. 2007 ; Vol. 196, No. 5.
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Relationship between abnormal fetal testing and adverse perinatal outcomes in intrauterine growth restriction. / Gonzalez, Juan M.; Stamilio, David M.; Ural, Serdar; Macones, George A.; Odibo, Anthony O.

In: American journal of obstetrics and gynecology, Vol. 196, No. 5, 01.05.2007.

Research output: Contribution to journalArticle

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