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Journal of Perinatal Medicine

Official Journal of the World Association of Perinatal Medicine

Editor-in-Chief: Dudenhausen, Joachim W.

Editorial Board Member: / Bancalari, Eduardo / Greenough, Anne / Genc, Mehmet R. / Chervenak, Frank A. / Chappelle, Joseph / Bergmann, Renate L. / Bernardes, J.F. / Bevilacqua, G. / Blickstein, Isaac / Cabero Roura, Luis / Carbonell-Estrany, Xavier / Carrera, Jose M. / D`Addario, Vincenzo / D'Alton, MD, Mary E. / Dimitrou, G. / Grunebaum, Amos / Hentschel, Roland / Köpcke, W. / Kawabata, Ichiro / Keirse, Marc J.N.C. / Kurjak M.D., Asim / Lee, Ben H. / Levene, Malcolm / Lockwood, Charles J. / Marsal, Karel / Makatsariya, Alexander / Nishida, Hiroshi / Ogata, Edward / Papp, Zoltán / Pejaver, Ranjan Kumar / Pooh, Ritsuko K. / Romero, Roberto / Saugstad, Ola D. / Schenker, Joseph G. / Sen, Cihat / Seri, Istvan / Vetter, Klaus / Winn, Hung N. / Young, Bruce K. / Zimmermann, Roland


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1619-3997
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Prediction of adverse perinatal outcome at term in small-for-gestational age fetuses: comparison of growth velocity vs. customized assessment

Ainara Iraola1 / Iñaki González2 / Elisenda Eixarch3 / Eva Meler4 / Miriam Illa5 / Jason Gardosi6 / Eduard Gratacós7 / Francesc Figueras8

1Department of Obstetrics, Hospital Clinic, Barcelona, Spain

2Department of Obstetrics, Hospital Clinic, Barcelona, Spain

3Department of Obstetrics, Hospital Clinic, Barcelona, Spain

4Department of Obstetrics, Hospital Clinic, Barcelona, Spain

5Department of Obstetrics, Hospital Clinic, Barcelona, Spain

6West Midlands Perinatal Institute, Birmingham, UK

7Department of Obstetrics, Hospital Clinic, Barcelona, Spain

8Department of Obstetrics, Hospital Clinic, Barcelona, Spain

Corresponding author: Ainara Iraola Department of Obstetrics Hospital Clinic Sabino de Arana n° 1 Barcelona, Spain Tel.: +34 932275600 Fax: +34 932275605

Citation Information: Journal of Perinatal Medicine. Volume 36, Issue 6, Pages 531–535, ISSN (Online) 1619-3997, ISSN (Print) 0300-5577, DOI: 10.1515/JPM.2008.100, November 2008

Publication History

Received:
2008-01-29
Revised:
2008-06-18
Accepted:
2008-06-23
Published Online:
2008-11-06

Abstract

Objective: To explore the ability of growth velocity and customized standards of fetal weight to predict adverse outcomes in small fetuses delivered at term.

Methods: We evaluated a cohort of 86 consecutive singletons suspected to be small for gestational age during the third trimester (estimated fetal weight <10th centile), who had normal umbilical artery Doppler and ultimately delivered at term. Conditional growth velocity and customized fetal growth were compared for the prediction of adverse outcome.

Results: Overall, customized growth assessment showed better sensitivity than growth velocity assessment (57.1% vs. 42.9% for a 10th centile cut-off) for the prediction of adverse outcome, but with comparable specificity. The odds of having an adverse outcome for women with a positive test compared with women with a negative test were 1.54 and 3.22 for the 10th centile growth velocity and customized definitions, respectively. The area under the curve for the prediction of adverse outcome was larger for customized than for growth velocity standards (0.65 vs. 0.59), albeit without statistical significance.

Conclusions: Our study suggests that customized growth assessment may have better accuracy in predicting adverse perinatal outcome than growth velocity in small fetuses with normal umbilical Doppler delivered at term.

Keywords: Conditional centiles; customized centiles; fetal growth; growth velocity; perinatal outcome

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