The risk of preterm birth associated with a low cerebroplacental ratio. (16th February 2019)

• Record Type: Journal Article
• Authors: Smith, Ashleigh; Flatley, Christopher; Kumar, Sailesh
• Is Part Of: Journal of maternal-fetal & neonatal medicine. Volume 32:Number 4(2019)
• Page Start: 610
• Page End: 616
• Publication Date: 2019-02-16
• Subjects: Caesarean section -- cerebroplacental ratio -- fetal Doppler ultrasound -- fetal growth restriction -- preterm birth; Obstetrics -- Periodicals; Perinatology -- Periodicals; Infants (Newborn) -- Diseases -- Periodicals; Neonatology -- Periodicals; 618.2
• DOI: 10.1080/14767058.2017.1387889
• Languages: English
• ISSNs: 1476-7058

Abstract

Abstract: Objective: This paper investigated whether a cerebroplacental ratio (CPR) < 10th centile (measured between 23 + 0–36 + 0 weeks gestation) is predictive of any preterm birth, birth within 2 weeks of the ultrasound scan or spontaneous preterm birth. Methods: This was a retrospective cohort study of 8977 women during 2014 and 2015 at a major tertiary referral hospital. Selection criteria included women who had a nonanomalous, singleton fetus and underwent an ultrasound scan between 23 + 0–36 + 6 weeks gestation. Results: A low CPR increased the risk of preterm birth or birth within 2 weeks of the scan with the highest odds of birth within 2 weeks seen at 28-week gestation (odds ratio (OR) 3.78, 95%CI 1.63–8.77) – the mode of delivery was most likely emergency caesarean section for nonreassuring fetal status (aOR 2.11, 95%CI 1.69–2.64, p < .001). Neonatal outcomes were worse in the low CPR cohort particularly with higher odds of death (aOR 2.30, 95%CI 1.46–3.63) and composite adverse outcome (aOR 1.46, 95%CI 1.24–1.73). The low CPR cohort had a significantly shorter interval to delivery (Cox Proportional Hazard – aHR 1.41, 95%CI 1.33–1.51, p < .001) and earlier gestation at birth. Conclusions: A low CPR is associated with an increased risk of preterm birth and birth within 2 weeks but not spontaneous preterm birth.