Abstract
Objective. To investigate if placental Doppler velocimetry can predict the recurrence of a small-for-gestational age (SGA) fetus in subsequent pregnancies. Design. Retrospective study. Setting. City cohort over 15 years attending a university hospital. Methods. A total of 196 pregnancies suspected of a SGA fetus (<3rd percentile) evaluated by uterine and umbilical artery Doppler velocimetry. Blood velocity waveform was analyzed for pulsatility index (PI) as well as the uterine artery waveform for notching in early diastole. Main outcome measure. The occurrence of a SGA newborn during the succeeding pregnancy by Doppler results from the previous pregnancy. Results. In the group of 196 pregnancies suspected for SGA, 27 (13.8%) delivered a SGA newborn in the following pregnancy. Thirty-seven (18.9%) of the 196 had an abnormally high PI in the uterine arteries in their first pregnancy, 12 (32.4%) of these delivered a SGA child in the next pregnancy (relative risk 3.44, p<0.001). The corresponding figure for those with normal uterine artery PI was 15 (9.4%). Abnormal umbilical artery Doppler was a worse predictor of recurrence of SGA (p=0.051). Uterine artery notching was not related to a SGA newborn during next pregnancy. Conclusion. The results suggest that abnormal uterine artery Doppler is related to increased risk of recurrence of SGA during the next pregnancy. This knowledge might provide the clinician with an opportunity to initiate preventive treatment and increase surveillance to women at risk during succeeding pregnancy.