Value of Cerebroplacental Ratio in Predicting Adverse Perinatal Outcome in Term Pregnancies Complicated by Obesity.

IF 2.4 4区医学 Q2 OBSTETRICS & GYNECOLOGY Geburtshilfe Und Frauenheilkunde Pub Date : 2024-08-22 eCollection Date: 2024-11-01 DOI:10.1055/a-2373-0722

Gabriel Eisenkolb, Anne Karge, Javier U Ortiz, Eva Ostermayer, Silvia M Lobmaier, Bettina Kuschel, Oliver Graupner

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Abstract

Objectives: To evaluate the performance of cerebroplacental ratio (CPR) in predicting composite adverse perinatal outcome (CAPO) in women with obesity compared to non-obese women at term.

Methods: This is a retrospective cohort study in a single tertiary referral centre over a 3-year period. All singleton pregnancies with CPR measurements ≥ 37 + 0 weeks and estimated fetal weight ≥ 10 ^th centile and attempted vaginal delivery were included and divided into two groups defined by pre-pregnancy body mass index (BMI) 2 . The presence of at least one of the following outcome parameters was defined as CAPO: operative delivery (OD) due to intrapartum fetal compromise (IFC), admission to the neonatal intensive care unit, umbilical cord arterial pH ≤ 7.15, 5 min Apgar < 7. The prognostic performance of CPR MoM was evaluated using receiver operating characteristic (ROC) analysis.

Results: The study cohort included 1207 pregnancies, of which 112 were women with a BMI ≥ 30 kg/m ² . In obese women, CAPO occurred in 21 cases (18.8%) compared to 247 (22.6%) cases in women with BMI < 30 kg/m ² (p = 0.404). In the entire study cohort, CPR MoM was significantly lower in the CAPO and OD for IFC group. ROC analyses revealed a significant predictive value of low CPR MoM for CAPO in obese women (AUC = 0.64, p = 0.024). Furthermore, CPR was predictive for OD for IFC not only in obese (AUC = 0.72, p = 0.023) but also in non-obese (AUC = 0.61, p = 0.003) women.

Conclusions: Low CPR MoM was predictive for CAPO and OD for IFC in obese women without additional risk factors. However, the overall predictive performance of CPR for CAPO in obese women was poor.

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预测肥胖症并发的足月妊娠不良围产期结果的脑-胎盘比率的价值

目的评估与非肥胖产妇相比，肥胖产妇的脑-胎盘比率（CPR）在预测围产期综合不良结局（CAPO）方面的性能：这是一项在一家三级转诊中心进行的回顾性队列研究，为期 3 年。所有心肺复苏测量值≥37+0 周、估计胎儿体重≥10th 百分位数且尝试过阴道分娩的单胎妊娠均被纳入研究，并按孕前体重指数（BMI）2 将其分为两组。以下至少一项结果参数被定义为 CAPO：因产时胎儿受损（IFC）导致的手术分娩（OD）、入住新生儿重症监护室、脐带动脉 pH ≤ 7.15、5 分钟 Apgar 结果：研究队列包括 1207 名孕妇，其中 112 名孕妇的体重指数（BMI）≥ 30 kg/m 2 。肥胖产妇中发生 CAPO 的有 21 例（18.8%），而体重指数为 2 的产妇有 247 例（22.6%）（p = 0.404）。在整个研究队列中，CAPO 组和 IFC OD 组的 CPR MoM 明显较低。ROC 分析显示，低 CPR MoM 对肥胖妇女的 CAPO 有显著的预测价值（AUC = 0.64，p = 0.024）。此外，不仅在肥胖（AUC = 0.72，p = 0.023）妇女中，在非肥胖（AUC = 0.61，p = 0.003）妇女中，心肺复苏对 IFC 的 OD 也有预测作用：结论：在没有其他风险因素的肥胖女性中，低 CPR MoM 可预测 CAPO，OD 可预测 IFC。然而，CPR 对肥胖女性 CAPO 的总体预测性能较差。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Geburtshilfe Und Frauenheilkunde 医学-妇产科学

CiteScore

2.50

自引率

22.20%

发文量

828

审稿时长

6-12 weeks

期刊介绍： Geburtshilfe und Frauenheilkunde (GebFra) addresses the whole field of obstetrics and gynecology and is concerned with research as much as with clinical practice. In its scientific section, it publishes original articles, reviews and case reports in all fields of the discipline, namely gynecological oncology, including oncology of the breast obstetrics and perinatal medicine, reproductive medicine, and urogynecology. GebFra invites the submission of original articles and review articles. In addition, the journal publishes guidelines, statements and recommendations in cooperation with the DGGG, SGGG, OEGGG and the Arbeitsgemeinschaft der Wissenschaftlichen Medizinischen Fachgesellschaften (AWMF, Association of Scientific Medical Societies, www.awmf.org). Apart from the scientific section, Geburtshilfe und Frauenheilkunde has a news and views section that also includes discussions, book reviews and professional information. Letters to the editors are welcome. If a letter discusses an article that has been published in our journal, the corresponding author of the article will be informed and invited to comment on the letter. The comment will be published along with the letter.