Skip to main content

Lund University Publications

LUND UNIVERSITY LIBRARIES

Longitudinal change in cerebro-placental ratio (CPR) between 37 and 40 weeks of pregnancy is associated with non-reassuring fetal status and increased risk of cesarean section

Cancemi, Annalisa ; Rial-Crestelo, Marta ; Martinez, Judit ; Giannone, Mariella ; Sánchez-Hoyo, Beatriz ; Izquierdo-Sánchez, Nora ; Cobos-Serrano, Cristina ; Matías-Ponce, Sonia ; Mayordomo-Gallardo, Sonia and Hansson, Stefan R. LU orcid , et al. (2023) In Journal of Maternal-Fetal and Neonatal Medicine 36(1).
Abstract

Objective: To evaluate in low-risk pregnancies if longitudinal change in cerebro-placental ratio (CPR) between 37 and 40 weeks of pregnancy is associated with cesarean section (CS) for non-reassuring fetal status (NRFS) during labor. Methods: This is a prospective observational study of women with singleton low-risk pregnancies who underwent an ultrasound scan at 36 + 0 to 37 + 6 and 39 + 0 to 41 + 6 weeks of pregnancy, when the CPR was calculated from the middle cerebral artery (MCA) and umbilical artery (UA) pulsatility indices. Managing professionals were kept blinded to the Doppler results. The association of the longitudinal change between both CPR (z-velocity) to CS for NRFS was evaluated by logistic regression. Results: A total... (More)

Objective: To evaluate in low-risk pregnancies if longitudinal change in cerebro-placental ratio (CPR) between 37 and 40 weeks of pregnancy is associated with cesarean section (CS) for non-reassuring fetal status (NRFS) during labor. Methods: This is a prospective observational study of women with singleton low-risk pregnancies who underwent an ultrasound scan at 36 + 0 to 37 + 6 and 39 + 0 to 41 + 6 weeks of pregnancy, when the CPR was calculated from the middle cerebral artery (MCA) and umbilical artery (UA) pulsatility indices. Managing professionals were kept blinded to the Doppler results. The association of the longitudinal change between both CPR (z-velocity) to CS for NRFS was evaluated by logistic regression. Results: A total of 401 pregnancies were included. The mean time interval between both CPR evaluations was 21 days (SD 7). A CS for fetal distress was performed in 7% of pregnancies. Independent of the CPR at 37 weeks, the likelihood of CS for fetal distress was significantly decreased by the longitudinal changes from 37 to 40 weeks (OR 0.61, 95%CI 0.4–0.92; p=.018). This association remained significant after further adjustment for potential confounders (nulliparity, maternal weight at booking and estimated fetal weight at 37): (OR 0.64, 95%CI 0.41–0.98; p=.044). Conclusions: The longitudinal change of CPR between 37 and 40 weeks is associated with the need for CS for NRFS during labor.

(Less)
Please use this url to cite or link to this publication:
author
; ; ; ; ; ; ; ; and , et al. (More)
; ; ; ; ; ; ; ; ; and (Less)
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
cerebro-placental ratio, Cesarean-section, fetal distress, longitudinal Doppler, singleton low-risk pregnancies
in
Journal of Maternal-Fetal and Neonatal Medicine
volume
36
issue
1
article number
2191776
publisher
Taylor & Francis
external identifiers
  • scopus:85150660285
  • pmid:36948221
ISSN
1476-7058
DOI
10.1080/14767058.2023.2191776
language
English
LU publication?
yes
id
efaa1a50-9a76-454f-93f0-ec9b7bf4616e
date added to LUP
2023-05-29 13:10:02
date last changed
2024-04-19 22:21:43
@article{efaa1a50-9a76-454f-93f0-ec9b7bf4616e,
  abstract     = {{<p>Objective: To evaluate in low-risk pregnancies if longitudinal change in cerebro-placental ratio (CPR) between 37 and 40 weeks of pregnancy is associated with cesarean section (CS) for non-reassuring fetal status (NRFS) during labor. Methods: This is a prospective observational study of women with singleton low-risk pregnancies who underwent an ultrasound scan at 36 + 0 to 37 + 6 and 39 + 0 to 41 + 6 weeks of pregnancy, when the CPR was calculated from the middle cerebral artery (MCA) and umbilical artery (UA) pulsatility indices. Managing professionals were kept blinded to the Doppler results. The association of the longitudinal change between both CPR (z-velocity) to CS for NRFS was evaluated by logistic regression. Results: A total of 401 pregnancies were included. The mean time interval between both CPR evaluations was 21 days (SD 7). A CS for fetal distress was performed in 7% of pregnancies. Independent of the CPR at 37 weeks, the likelihood of CS for fetal distress was significantly decreased by the longitudinal changes from 37 to 40 weeks (OR 0.61, 95%CI 0.4–0.92; p=.018). This association remained significant after further adjustment for potential confounders (nulliparity, maternal weight at booking and estimated fetal weight at 37): (OR 0.64, 95%CI 0.41–0.98; p=.044). Conclusions: The longitudinal change of CPR between 37 and 40 weeks is associated with the need for CS for NRFS during labor.</p>}},
  author       = {{Cancemi, Annalisa and Rial-Crestelo, Marta and Martinez, Judit and Giannone, Mariella and Sánchez-Hoyo, Beatriz and Izquierdo-Sánchez, Nora and Cobos-Serrano, Cristina and Matías-Ponce, Sonia and Mayordomo-Gallardo, Sonia and Hansson, Stefan R. and Figueras, Francesc}},
  issn         = {{1476-7058}},
  keywords     = {{cerebro-placental ratio; Cesarean-section; fetal distress; longitudinal Doppler; singleton low-risk pregnancies}},
  language     = {{eng}},
  number       = {{1}},
  publisher    = {{Taylor & Francis}},
  series       = {{Journal of Maternal-Fetal and Neonatal Medicine}},
  title        = {{Longitudinal change in cerebro-placental ratio (CPR) between 37 and 40 weeks of pregnancy is associated with non-reassuring fetal status and increased risk of cesarean section}},
  url          = {{http://dx.doi.org/10.1080/14767058.2023.2191776}},
  doi          = {{10.1080/14767058.2023.2191776}},
  volume       = {{36}},
  year         = {{2023}},
}