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dc.contributor.authorOrmesher, L.
dc.contributor.authorWarrander, L.
dc.contributor.authorLiu, Y.
dc.contributor.authorThomas, S.
dc.contributor.authorSimcox, L.
dc.contributor.authorSmith, G. C. S.
dc.contributor.authorMyers, J. E.
dc.contributor.authorJohnstone, E. D.
dc.date.accessioned2020-12-22T18:57:40Z
dc.date.available2020-12-22T18:57:40Z
dc.date.issued2020-12-17
dc.date.submitted2020-06-01
dc.identifier.others41598-020-78631-5
dc.identifier.other78631
dc.identifier.urihttps://www.repository.cam.ac.uk/handle/1810/315438
dc.descriptionFunder: Tommy's Baby Charity; doi: http://dx.doi.org/10.13039/501100000306
dc.descriptionFunder: Manchester University NHS Foundation Trust
dc.description.abstractAbstract: Abnormal maternal serum biomarkers (AMSB), identified through the aneuploidy screening programme, are frequent incidental findings in pregnancy. They are associated with fetal growth restriction (FGR), but previous studies have not examined whether this association is with early-onset (< 34 weeks) or late-onset (> 34 weeks) FGR; as a result there is no consensus on management. The aims of this study were to determine the prevalence and phenotype of FGR in women with AMSB and test the predictive value of placental sonographic screening to predict early-onset FGR. 1196 pregnant women with AMSB underwent a 21–24 week “placental screen” comprising fetal and placental size, and uterine artery Doppler. Multivariable regression was used to calculate a predictive model for early-onset FGR (birthweight centile < 3rd/< 10th with absent umbilical end-diastolic flow, < 34 weeks). FGR prevalence was high (10.3%), however early-onset FGR was uncommon (2.3%). Placental screening effectively identified early-onset (area under the curve (AUC) 0.93, 95% confidence interval (CI) 0.87–1.00), but not late-onset FGR (AUC 0.70, 95% CI 0.64–0.75). Internal validation demonstrated robust performance for detection/exclusion of early-onset FGR. In this cohort, utilisation of our proposed algorithm with targeted fetal growth and Doppler surveillance, compared with universal comprehensive surveillance would have avoided 1044 scans, potentiating significant cost-saving for maternity services.
dc.languageen
dc.publisherNature Publishing Group UK
dc.rightsAttribution 4.0 International (CC BY 4.0)en
dc.rights.urihttps://creativecommons.org/licenses/by/4.0/en
dc.subjectArticle
dc.subject/631/1647/245/1859
dc.subject/639/705/531
dc.subject/692/700/1750/1747
dc.subject/692/308/53/2423
dc.subjectarticle
dc.titleRisk stratification for early-onset fetal growth restriction in women with abnormal serum biomarkers: a retrospective cohort study
dc.typeArticle
dc.date.updated2020-12-22T18:57:39Z
prism.issueIdentifier1
prism.publicationNameScientific Reports
prism.volume10
dc.identifier.doi10.17863/CAM.62545
dcterms.dateAccepted2020-10-28
rioxxterms.versionofrecord10.1038/s41598-020-78631-5
rioxxterms.versionVoR
rioxxterms.licenseref.urihttp://creativecommons.org/licenses/by/4.0/
dc.identifier.eissn2045-2322


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Attribution 4.0 International (CC BY 4.0)
Except where otherwise noted, this item's licence is described as Attribution 4.0 International (CC BY 4.0)