Imperial College London
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DrBonnieMylrea Lowndes

Faculty of Medicine, Department of Metabolism, Digestion and Reproduction

Research Postgraduate
 
 
 
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Contact

 

+44 (0)20 7594 8698b.mylrea-foley

 
 
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Location

 

Centre for Fetal CareQueen Charlottes and Chelsea HospitalHammersmith Campus

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Summary

 

Publications

Citation

BibTex format

@article{Mylrea-Foley:2023:10.1016/j.ajogmf.2023.101117,
author = {Mylrea-Foley, B and Napolitano, R and Gordijn, S and Wolf, H and Lees, CC and Stampalija, T and TRUFFLE-2, Feasibility Study Authors},
doi = {10.1016/j.ajogmf.2023.101117},
journal = {Am J Obstet Gynecol MFM},
title = {Do differences in diagnostic criteria for late fetal growth restriction matter?},
url = {http://dx.doi.org/10.1016/j.ajogmf.2023.101117},
volume = {5},
year = {2023}
}
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RIS format (EndNote, RefMan)

TY  - JOUR
AB  - BACKGROUND: Criteria for diagnosis of fetal growth restriction differ widely according to national and international guidelines, and further heterogeneity arises from the use of different biometric and Doppler reference charts, making the diagnosis of fetal growth restriction highly variable. OBJECTIVE: This study aimed to compare fetal growth restriction definitions between Delphi consensus and Society for Maternal-Fetal Medicine definitions, using different standards/charts for fetal biometry and different reference ranges for Doppler velocimetry parameters. STUDY DESIGN: From the TRUFFLE 2 feasibility study (856 women with singleton pregnancy at 32+0 to 36+6 weeks of gestation and at risk of fetal growth restriction), we selected 564 women with available mid-pregnancy biometry. For the comparison, we used standards/charts for estimated fetal weight and abdominal circumference from Hadlock, INTERGROWTH-21st, and GROW and Chitty. Percentiles for umbilical artery pulsatility index and its ratios with middle cerebral artery pulsatility index were calculated using Arduini and Ebbing reference charts. Sensitivity and specificity for low birthweight and adverse perinatal outcome were evaluated. RESULTS: Different combinations of definitions and reference charts identified substantially different proportions of fetuses within our population as having fetal growth restriction, varying from 38% (with Delphi consensus definition, INTERGROWTH-21st biometric standards, and Arduini Doppler reference ranges) to 93% (with Society for Maternal-Fetal Medicine definition and Hadlock biometric standards). None of the different combinations tested appeared effective, with relative risk for birthweight <10th percentile between 1.4 and 2.1. Birthweight <10th percentile was observed most frequently when selection was made with the GROW/Chitty charts, slightly less with the Hadlock standard, and least frequently with the INTERGROWTH-21st standard. Using the Ebbing Doppler reference
AU  - Mylrea-Foley,B
AU  - Napolitano,R
AU  - Gordijn,S
AU  - Wolf,H
AU  - Lees,CC
AU  - Stampalija,T
AU  - TRUFFLE-2,Feasibility Study Authors
DO  - 10.1016/j.ajogmf.2023.101117
PY  - 2023///
TI  - Do differences in diagnostic criteria for late fetal growth restriction matter?
T2  - Am J Obstet Gynecol MFM
UR  - http://dx.doi.org/10.1016/j.ajogmf.2023.101117
UR  - https://www.ncbi.nlm.nih.gov/pubmed/37544409
VL  - 5
ER  -
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