Prediction of late-onset fetal growth restriction by umbilical artery velocities at 37 weeks of gestation: a cross-sectional study

Abstract

Objective: To explore the predictive capacity of umbilical artery (UA) velocities at 37 weeks of gestation in identifying fetal growth restriction (FGR).

Design: Cross-sectional study.

Setting and participants: We retrospectively recruited 569 fetuses in the study. Thirty-nine FGR infants and 57 small-for-gestational-age (SGA) infants with normal UA Doppler at 37 weeks, as the study groups and 473 adequate-for-gestational-age (AGA) infants as a control group in a tertiary referral centre.

Methods: All the parameters of UA velocities, including the UA end-diastolic velocity (UA-EDV), UA peak systolic velocity (UA-PSV), UA mean diastolic velocity (UA-MDV) and UA time-averaged maximum velocity (UA-TAMXV), and UA Doppler were measured at approximately 37 weeks of gestation.

Results: Among the FGR, SGA and AGA groups, the UA-MDV, UA-TAMXV, UA-PSV and UA-EDV decreased with the loss of fetal weight. Multivariate logistic regression analyses showed that the UA-TAMXV was an independent predicting factor of FGR. It had a moderate predictive value for FGR. The area under the receiver operating characteristic curve was 0.82 (95% CI: 0.79 to 0.85).

Conclusions: The UA velocities decreased with the loss of fetal weight among the FGR, SGA and AGA groups and the UA-TAMXV was independently predictive of FGR. The results suggest that the UA-TAMXV might be a new parameter to predict FGR prior to delivery.

Keywords: Fetal medicine; Prenatal diagnosis; Ultrasonography.