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

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.