Gana Nicoleta, Ianosev Dragana, Allafi Nima, Impis Oglou Mechmet, Nicolaides Kypros H
Faculty of Medicine, Carol Davila University of Medicine and Pharmacy, 020021 Bucharest, Romania.
Harris Birthright Research Centre for Fetal Medicine, King's College, London SE5 8BB, UK.
J Clin Med. 2025 Jun 21;14(13):4425. doi: 10.3390/jcm14134425.
Small-for-gestational-age (SGA) status constitutes a significant risk factor for adverse neonatal outcomes and predisposes individuals to long-term health complications. Detecting pregnancies at risk early in gestation could significantly improve perinatal outcomes. Recent evidence suggests that ophthalmic artery Doppler assessment in the first trimester may contribute to the prediction of impaired placentation reflected in increased risk for preeclampsia. This study aimed to investigate the association between first-trimester ophthalmic artery Doppler parameters and the subsequent birth of small-for-gestational-age (SGA) neonates. In this prospective observational analysis, 4054 pregnant women underwent ophthalmic artery Doppler evaluation at 11-13 weeks gestation. Maternal demographics, biophysical and biochemical markers, and ophthalmic artery Doppler measurements of pulsatility index (PI) and peak systolic velocity (PSV) ratio were obtained. Outcomes were classified based on birthweight into the ≤3rd percentile and >3rd percentile and ≤10th percentile and >10th percentile groups. To determine the predictive value of Doppler indices, statistical methods included comparative analyses and the receiver operating characteristic (ROC) curves. The analysis indicated that increased PSV ratio at 11-13 weeks gestation correlated with an increased risk of SGA. The PI was not found to be a significant discriminator between pregnancies complicated by SGA and non-SGA pregnancies. First-trimester ophthalmic artery Doppler assessment offers promise as a non-invasive technique for the early identification of pregnancies at risk for SGA neonates. Further validation through large, multicenter studies is needed to confirm its utility and to standardize its use in clinical protocols.
小于胎龄（SGA）状态是不良新生儿结局的重要危险因素，使个体易患长期健康并发症。在妊娠早期检测出有风险的妊娠可显著改善围产期结局。最近的证据表明，孕早期的眼动脉多普勒评估可能有助于预测胎盘功能受损，这表现为子痫前期风险增加。本研究旨在调查孕早期眼动脉多普勒参数与随后小于胎龄（SGA）新生儿出生之间的关联。在这项前瞻性观察分析中，4054名孕妇在妊娠11 - 13周时接受了眼动脉多普勒评估。获取了产妇的人口统计学信息、生物物理和生化指标，以及眼动脉多普勒测量的搏动指数（PI）和收缩期峰值速度（PSV）比值。结局根据出生体重分为≤第3百分位数和>第3百分位数以及≤第10百分位数和>第10百分位数组。为了确定多普勒指数的预测价值，统计方法包括比较分析和受试者操作特征（ROC）曲线。分析表明，妊娠11 - 13周时PSV比值升高与SGA风险增加相关。未发现PI是SGA妊娠和非SGA妊娠之间的显著区分指标。孕早期眼动脉多普勒评估作为一种非侵入性技术，有望早期识别有SGA新生儿风险的妊娠。需要通过大型多中心研究进行进一步验证，以确认其效用并规范其在临床方案中的应用。
