Clinical and anamnestic factors in the prediction and diagnosis of fetal growth restriction

封面

如何引用文章

全文:

开放存取 开放存取
受限制的访问 ##reader.subscriptionAccessGranted##
受限制的访问 订阅或者付费存取

详细

Objective: To develop a model for predicting and diagnosing fetal growth restriction based on clinical and anamnestic factors and examination data during pregnancy.

Materials and methods: Postnatally, the weight and growth parameters of 473 newborns were assessed according to the INTERGROWTH-21 centile curves, which made it possible to form a study group that included 202 pregnant women with fetal growth restriction. The comparison group included 206 women without fetal growth restriction who delivered at terms corresponding to the terms in the study group. Risk factors, parameters of somatic and gynecological anamnesis, features of the course of pregnancy and delivery, ultrasound and Doppler data, and a comprehensive assessment of the health status of newborns were analyzed. After statistical processing of the parameters, binary logistic regression was used to develop a mathematical model for predicting fetal growth restriction.

Results: The prognostic model based on binary logistic regression, including somatic and gynecological diseases and medical history, had a sensitivity of 55.6% and specificity of 82.3%. When physical examination data during pregnancy, including fetal abdominal circumference as measured by ultrasound, were added, the model had a sensitivity of 96.7% and a specificity of 76.8%.

Conclusion: The models developed using the binary logistic regression method can be proposed for use in practical healthcare to identify risk groups and predict and diagnose fetal growth retardation, which will allow for timely prevention to reduce the incidence of perinatal complications.

全文:

受限制的访问

作者简介

Maria Volochaeva

Academician V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology, Ministry of Health of the Russian Federation

编辑信件的主要联系方式.
Email: volochaeva.m@yandex.ru
ORCID iD: 0000-0001-8953-7952

PhD, Senior Researcher at the Department of Regional Cooperation and Integration, Physician at the 1 Maternity Department

俄罗斯联邦, Moscow

Natalia Kan

Academician V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology, Ministry of Health of the Russian Federation

Email: kan-med@mail.ru
ORCID iD: 0000-0001-5087-5946
SPIN 代码: 5378-8437
Scopus 作者 ID: 57008835600
Researcher ID: B-2370-2015

Dr. Med. Sci., Professor, Deputy Director for Research

俄罗斯联邦, Moscow

Victor Tyutyunnik

Academician V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology, Ministry of Health of the Russian Federation

Email: tioutiounnik@mail.ru
ORCID iD: 0000-0002-5830-5099
SPIN 代码: 1963-1359
Scopus 作者 ID: 56190621500
Researcher ID: B-2364-2015

Dr. Med. Sci., Professor, Leading Researcher at the Department of Research Administration

俄罗斯联邦, Moscow

Elrad Amiraslanov

Academician V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology, Ministry of Health of the Russian Federation

Email: e_amiraslanov@oparina4.ru
ORCID iD: 0000-0001-5601-1241
SPIN 代码: 7601-2404
Scopus 作者 ID: 57009098500

PhD, Head of the Department of Obstetrics

俄罗斯联邦, Moscow

Anastasia Leonova

Academician V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology, Ministry of Health of the Russian Federation

Email: nastena27-03@mail.ru
ORCID iD: 0000-0001-6707-3464

Postgraduate Student

俄罗斯联邦, Moscow

Ekaterina Soldatova

Academician V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology, Ministry of Health of the Russian Federation

Email: katerina.soldatova95@bk.ru
ORCID iD: 0000-0001-6463-3403

Postgraduate Student

俄罗斯联邦, Moscow

参考

  1. Melamed N., Baschat A., Yinon Y., Athanasiadis A., Mecacci F., Figueras F. et al. FIGO (International Federation of Gynecology and Obstetrics) initiative on fetal growth: best practice advice for screening, diagnosis, and management of fetal growth restriction. Int. J. Gynaecol. Obstet. 2021; 152(Suppl. 1): 3-57. https://dx.doi.org/10.1002/ijgo.13522.
  2. Министерство здравоохранения Российской Федерации. Недостаточный рост плода, требующий предоставления медицинской помощи матери (задержка роста плода). Клинические рекомендации (протокол лечения). М.; 2022. 71с. [Ministry of Health of the Russian Federation. Insufficient growth of the fetus, requiring the provision of medical care to the mother (fetal growth retardation). Clinical guidelines (treatment protocol). Moscow; 2022. 71p. (in Russian)]. Available at: https://cr.minzdrav.gov.ru/schema/722_1
  3. Whitehead C.L., McCarthy F.P., Kingdom J. Fetal growth restriction: diagnosis and management. In: Kilby M., Johnson A., Oepkes D., eds. Fetal therapy: Scientific basis and critical appraisal of clinical benefits. 2th ed. Cambridge: Cambridge University Press; 2020: 264-78. https://dx.doi.org/10.1017/9781108564434.025.
  4. Salmeri N., Carbone I.F., Cavoretto P.I., Farina A., Morano D. Epigenetics beyond fetal growth restriction: a comprehensive overview. Mol. Diagn. Ther. 2022; 26(6): 607-6. https://dx.doi.org/10.1007/s40291-022-00611-4.
  5. Miller S.L., Huppi P.S., Mallard C. The consequences of fetal growth restriction on brain structure and neurodevelopmental outcome. J. Physiol. 2016; 594(4): 807-23. https://dx.doi.org/10.1113/JP271402.
  6. ACOG practice bulletin No. 227: fetal growth restriction. Obstet. Gynecol. 2021; 137(2): 16-28. https://dx.doi.org/10.1097/AOG.0000000000004350.
  7. Sun C., Groom K.M., Oyston C., Chamley L.W., Clark A.R., James J.L. The placenta in fetal growth restriction: what is going wrong? Placenta. 2020; 96: 10-8. https://dx.doi.org/10.1016/j.placenta.2020.05.003.
  8. Lackman F., Capewell V., Gagnon R., Richardson B. Fetal umbilical cord oxygen values and birth to placental weight ratio in relation to size at birth. Am. J. Obstet. Gynecol. 2001; 185(3): 674-82. https://dx.doi.org/10.1067/mob.2001.116686.
  9. Figueras F., Gratacos E. An integrated approach to fetal growth restriction. Best Pract. Res. Clin. Obstet. Gynaecol. 2017; 38: 48-58. https://dx.doi.org/10.1016/j.bpobgyn.2016.10.006.
  10. Nardozza L.M., Caetano A.C., Zamarian A.C., Mazzola J.B., Silva C.P., Marçal V.M. et al. Fetal growth restriction: current knowledge. Arch. Gynecol. Obstet. 2017; 295(5): 1061-77. https://dx.doi.org/10.1007/s00404-017-4341-9.
  11. Suhag A., Berghella V. Intrauterine growth restriction (IUGR): etiology and diagnosis. Curr. Obstet. Gynecol. 2013; 2(2): 102-11. https://dx.doi.org/10.1007/s13669-013-0041-z.
  12. Damhuis S.E., Ganzevoort W., Gordijn S.J. Abnormal fetal growth: small for gestational age, fetal growth restriction, large for gestational age: definitions and epidemiology. Obstet. Gynecol. Clin. North Am. 2021; 48(2): 267-79. https://dx.doi.org/10.1016/j.ogc.2021.02.002.
  13. Stacey T., Thompson J.M., Mitchell E.A., Zuccollo J.M., Ekeroma A.J., McCowan L.M. Antenatal care, identification of suboptimal fetal growth and risk of late stillbirth: findings from the Auckland Stillbirth Study. Aust. N. Z. J. Obstet. Gynaecol. 2012; 52(3): 242-7. https://dx.doi.org/10.1111/ j.1479-828X.2011.01406.x.
  14. Froen J.F., Gardosi J.O., Thurmann A., Francis A., Stray-Pedersen B. Restricted fetal growth in sudden intrauterine unexplained death. Acta Obstet. Gynecol. Scand. 2004; 83(9): 801-7. https://dx.doi.org/10.1111/ j.0001-6349.2004.00602.x.
  15. Ганичкина М.Б., Мантрова Д.А., Кан Н.Е., Тютюнник В.Л., Хачатурян А.А., Зиганшина М.М. Ведение беременности при задержке роста плода. Акушерство и гинекология. 2017; 10: 5-11. [Ganichkina М.B., Mantrova D.A., Kan N.E., Tyutyunnik V.L., Khachaturyan A.A., Ziganshina M.M. Pregnancy management with fetal growth retardation. Obstetrics and Gynecology. 2017; (10): 5-11. (in Russian)]. https://dx.doi.org/10.18565/aig.2017.10.5-11.
  16. Verlohren S., Herraiz I., Lapaire O., Schlembach D., Zeisler H., Calda P. et al. New gestational phase-specific cutoff values for the use of the soluble fms-like tyrosine kinase-1/placental growth factor ratio as a diagnostic test for preeclampsia. Hypertension. 2014; 63(2): 346-52. https://dx.doi.org/10.1161/HYPERTENSIONAHA.113.01787.
  17. Gardosi J., Madurasinghe V., Williams M., Malik A., Francis A. Maternal and fetal risk factors for stillbirth: population based study. BMJ. 2013; 346:108-9. https://dx.doi.org/10.1136/bmj.f108.
  18. Papastefanou I., Wright D., Syngelaki A., Akolekar R., Nicolaides K.H. Personalized stratification of pregnancy care for small for gestational age neonates from biophysical markers at midgestation. Am. J. Obstet. Gynecol. 2022; 229(1): 57.e1-57.e14. https://dx.doi.org/10.1016/j.ajog.2022.12.318.
  19. Ярыгина Т.А., Батаева Р.С. Прогнозирование рождения маловесного для гестационного возраста ребенка: оценка эффективности алгоритма Фонда медицины плода (Fetal Medicine Foundation) в первом триместре беременности. Ультразвуковая и функциональная диагностика. 2019; 2: 16-32. [Yarygina T.A., Bataeva R.S. Performance of screening for small-for-gestational age newborn at first trimester using the algorithm proposed by the Fetal Medicine Foundation. Ultrasound and Functional Diagnostics. 2019; (2): 16-32. (in Russian)]. https://dx.doi.org/10.24835/1607-0771-2019-2-16-32.
  20. Sharp A., Duong C., Agarwal U., Alfirevic Z. Screening and management of the small for gestational age fetus in the UK: A survey of practice. Eur. J. Obstet. Gynecol. Reprod. Biol. 2018; 231: 220-4. https://dx.doi.org/10.1016/ j.ejogrb.2018.10.039.
  21. García B., Llurba E., Valle L., Gómez-Roig M.D., Juan M., Pérez-Matos C. et al. Do knowledge of uterine artery resistance in the second trimester and targeted surveillance improve maternal and perinatal outcome? UTOPIA study: a randomized controlled trial. Ultrasound Obstet. Gynecol. 2016; 47(6): 680-9. https://dx.doi.org/10.1002/uog.15873.
  22. Crovetto F., Triunfo S., Crispi F., Rodriguez-Sureda V., Dominguez C., Figueras F., Gratacos E. Differential performance of first-trimester screening in predicting small-for-gestational-age neonate or fetal growth restriction. Ultrasound Obstet. Gynecol. 2017; 49(3): 349-56. https://dx.doi.org/10.1002/uog.15919.
  23. Гуменюк Е.Г., Ившин А.А., Болдина Ю.С. Поиск предикторов задержки роста плода: от сантиметровой ленты до искусcтвенного интеллекта. Акушерство и гинекология. 2022; 12: 18-24. [Gumenyuk E.G., Ivshin A.A., Boldina Yu.S. Search for predictors of fetal growth retardation: from centimeter tape to artificial intelligence. Obstetrics and Gynecology. 2022; (12): 18-24. (in Russian)]. https://dx.doi.org/10.18565/aig.2022.185.
  24. Haragan A., Himes K. Accuracy of ultrasound estimated fetal weight in small for gestational age and appropriate for gestational age grown periviable neonates. Am. J. Perinatol. 2018; 35(8): 703-6. https://dx.doi.org/10.1055/s-0037-1617433.
  25. Bahado-Singh R.O., Yilmaz A., Bisgin H., Turkoglu O., Kumar P., Sherman E. et al. Artificial intelligence and the analysis of multi-platform metabolomics data for the detection of intrauterine growth restriction. PLoS One. 2019; 14(4): e0214121. https://dx.doi.org/10.1371/journal.pone.0214121.
  26. Hoopmann M., Bernau B., Hart N., Schild R.L., Siemer J. Do specific weight formulas for fetuses < or = 1500 g really improve weight estimation? Ultchall Med. 2010; 31(1): 48-52. https://dx.doi.org/10.1055/s-0028-1109481.
  27. Ярыгина Т.А., Гус А.И. Задержка (замедление) роста плода: все, что необходимо знать практикующему врачу. Акушерство и гинекология. 2020; 12: 14-24. [Yarygina T.A., Gus A.I. Fetal growth retardation: everything a practitioner needs to know. Obstetrics and Gynecology. 2020; (12): 14-24. (in Russian)]. https://dx.doi.org/10.18565/aig.2020.12.14-24.
  28. Armengaud J.B., Yzydorczyk C., Siddeek B., Peyter A.C., Simeoni U. Intrauterine growth restriction:clinical consequences on health and disease at adulthood. Reprod. Toxicol. 2021; 99: 168-76. https://dx.doi.org/10.1016/ j.reprotox.2020.10.005.
  29. Herraiz I., Simón E., Gómez-Arriaga P.I., Quezada M.S., García-Burguillo A., López-Jiménez E.A., Galindo A. Clinical implementation of the sFlt-1/PlGF ratio to identify preeclampsia and fetal growth restriction: A prospective cohort study. Pregnancy Hypertens. 2018; 13: 279-85. https://dx.doi.org/10.1016/ j.preghy.2018.06.017.

补充文件

附件文件
动作
1. JATS XML
2. Fig. 1. ROC curve characterizing the dependence of the probability of fetal growth retardation on the value of the logistic function P

下载 (181KB)
3. Fig. 2. ROC curve characterizing the dependence of fetal growth retardation prediction on the value of the logistic function P

下载 (172KB)

版权所有 © Bionika Media, 2023
##common.cookie##