Abdominal circumference growth velocity as a predictor of adverse perinatal outcomes in small-for-gestational-age fetuses

Abstract

Objective

To assess the predictive value of abdominal circumference growth velocity (ACGV) between the second and third trimesters to predict adverse perinatal outcomes in a cohort of small-for-gestational-age fetuses without evidence of placental insufficiency (i.e. fetal growth restriction).

Material and methods

This is a single-center retrospective cohort study of all singleton pregnancies with small-for-gestational-age fetuses diagnosed and delivered at a quaternary institution. Crude and adjusted odds ratios (ORs) and corresponding confidence intervals (CIs) were calculated via logistic regression models to assess the potential association between abnormal ACGV (i.e. ≤10th centile) and adverse perinatal outcomes defined as a composite outcome (i.e. umbilical artery pH <7.1, 5-min Apgar score <7, admission to the neonatal intensive care unit, hypoglycemia, intrapartum fetal distress requiring expedited delivery, and perinatal death). Furthermore, the area under the receiver-operating characteristic curve (AUC) of three logistic regression models based on estimated fetal weight and ACGV for predicting the composite outcome is also reported.

Results

A total of 154 pregnancies were included for analysis. The median birthweight for the cohort was 2,437 g (interquartile range [IQR] 2280, 2635). Overall, the primary composite outcome was relatively common (29.2%). In addition, there was a significant association between abnormal ACGV and adverse perinatal outcomes (OR 3.37, 95% CI 1.60, 7.13; adjusted OR 4.30, 95% CI 1.77, 10.49). Likewise, the AUC for the ACGV was marginally higher (0.64) than the estimated fetal weight (0.54) and ACGV + estimated fetal weight (0.54). Still, no significant difference was detected between the curves (p = 0.297).

Conclusions

Our results suggest that an ACGV below the 10th centile is a risk factor for adverse perinatal outcomes among small-for-gestational-age fetuses.

Keywords:

• Fetal growth
• growth velocity
• abdominal circumference growth velocity
• small-for-gestational-age
• perinatal outcomes
• estimated fetal weight

Acknowledgments

The authors wish to thank the staff of the Maternal-Fetal Medicine Department at the National Perinatology Institute, where this study was conducted, for their support and guidance.

Disclosure statement

The authors declare that they have no known competing financial interests or personal relationships that could have influenced the work reported in this manuscript.

Data availability statement

The data that support the findings of this study are available from the corresponding author, [MJ-RS], upon reasonable request.

Additional information

Funding

No funding was obtained for the present study.