Longitudinal change in cerebro-placental ratio (CPR) between 37 and 40 weeks of pregnancy is associated with non-reassuring fetal status and increased risk of cesarean section

Figures & data

Table 1. Baseline characteristics of the cohort (n = 401).

	N = 401
Maternal age (years); mean (SD); range	32.8 (4.5); 20–42
Weight at booking; mean (SD); range	62.4 (9.8); 40–108
Neonatal weight percentile; mean (SD)	48.42 (29.9); 1–100
Nulliparity; (%)	191; 57
Smoking: (%)	15; 3.7
Birthweight (g); mean (SD)	3422 (388) (2400, 4460)
5-min Apgar score; median (IQR)	9.19 (7–10)
NICU admission (days); (%)	0.16; (5)
GA at delivery (weeks); mean (SD)	39.9 (4)
Cesarean for fetal distress; (%)	28; 7
Neonatal acidosis; (%) UA pHa <7.15 and base excess >–12 mEq/L	59 (14.7)

NICU: neonatal intensive care unit; UA: umbilical artery; GA: gestational age.

Data shown as mean (SD), range.

Figure 1. Individual trend in CPR z-values by the occurrence of CS for NRFS.

Table 2. Perinatal outcomes by CPR z-velocity quartile.

	CPR z-velocity in the 1st quartile	CPR z-velocity in the 2nd–4th quartile	p Value
N	100	301
Gestational age at first CPR, mean (SD)	36.9 (0.84)	37.5 (1.22)	.000*
Gestational age at second CPR, mean (SD)	39.7 (0.75)	39.4 (0.92)	.009*
GA at delivery (weeks); mean (SD)	39.9 (4.1)	39.9 (4.1)	.982
5-min Apgar score ≤7; %	2; 2%)	1; (0.33%)	.098
NICU admission; (%)	6; (6%)	15; (4.9%)	.714
Cesarean for NRFS; (%)	13; (13%)	14; (4.7%)	.004*
Neonatal acidosis; (%)	17; (17%)	40; (13.2%)	.402*
Composite adverse outcome (CAPO); (%)	31; (31%)	61; (20.3%)	.027*

NICU: neonatal intensive care unit; NRFS: non-reassuring fetal status.

Data shown as mean (SD), range. Composite adverse outcome (CAPO) was defined as NRFS cesarean section or admission to NICU more than three days or neonatal acidosis.

*significance is considered when p < .05.

Table 3. Logistic regression analysis for cesarean section for fetal distress.

			95%CI
	p Value	OR	Inferior	Superior
(a) Only for two variables: z-cpr (first cerebro-placental measure); z-velocity: longitudinal change between both CPR measurements
z-cpr	.782	0.9	0.605	1.459
z-velocity	.018*	0.6	0.403	0.918
			95%CI
	p Value	OR	Inferior	Superior
(b) Taking into account other maternal/fetal basal characteristics: nulliparity, weight at booking and EFW (estimated fetal weight)
Nulliparity	.077	2.4	0.910	6.362
Weight at booking	.574	0.9	0.941	1.034
Estimated fetal weight	.492	1	0.979	1.01
z-cpr	.866	0.96	0.601	1.536
z-velocity	.044*	0.64	0.412	0.987

*significance is considered when p < .05.