Uterine artery Doppler velocimetry and maternal weight gain by the mid-second trimester for prediction of fetal growth restriction

Abstract

OBJECTIVE: To investigate whether assessment of maternal weight gain up to mid-second trimester improves the predictive value of uterine artery Doppler velocimetry (UAD) for the prediction of fetal growth restriction (FGR).

SETTING: Department of Obstetrics and Gynecology, Yonsei University College of Medicine.

DESIGN: Prospective Doppler measurements coupled to retrospective chart review.

POPULATION: A total of 10,970 women delivering at the institution.

OUTCOME MEASURES: Maternal weight gain up to mid-second trimester and Doppler ultrasonography on bilateral uterine arteries between 20 and 24 weeks' gestation. Low weight gain was defined as <0.2 kg/week and FGR as birthweight of <10th percentile.

RESULTS: ith that combined with the measurement of maternal weight gain for the prediction of the FGR. The odd ratios for FGR were 2.56 (95% CI 1.59-4.12) in the group with normal UAD and abnormal weight gain (normal-abnormal group), 1.91 (95% CI 0.98-3.7) in the abnormal-normal group and 40.3 (95% CI 16.9-96.4) in the abnormal-abnormal group. UAD independent of weight gain had a sensitivity of 31.5%, a specificity of 88%, a positive predictive value (PPV) of 24.5% and a negative predictive value (NPV) of 91.2%. When mid-trimester maternal weight gain was accounted for, the sensitivity of UAD was 64.9%, specificity 64.1%, PPV 73.3% and NPV 93.6%.

CONCLUSION: The diagnostic performance of UAD for FGR improved significantly when the degree of maternal weight gain until the mid-second trimester was taken into account. Closer antenatal surveillance might be required in women with abnormal uterine Doppler velocimetry if their mid-second trimester weight gain is poor.