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  • Title: Predicting small for gestational age in the first trimester of pregnancy using maternal ophthalmic artery Doppler indices.
    Author: Gurgel Alves JA, Maia e Holanda Moura SB, Araujo Júnior E, Tonni G, Martins WP, Da Silva Costa F.
    Journal: J Matern Fetal Neonatal Med; 2016; 29(7):1190-4. PubMed ID: 26030678.
    Abstract:
    OBJECTIVE: To assess the capacity of maternal ophthalmic Doppler indices for predicting small for gestational age (SGA) newborns in the first trimester of pregnancy. METHODS: We performed a prospective observational cohort study involving 499 singleton pregnancies during the first trimester scan (11-14 weeks). The following maternal ophthalmic Doppler indices were assessed: pulsatility index (PI), first diastolic peak velocity (PD1) and peak ratio (PR) = PD1/peak systolic velocity. We considered SGA all newborns with weight below 10th percentile. We used chi-square test (χ(2)) to compare the groups. We used area under receiver operating characteristics (ROC) curves with 95% confidence intervals (CI) and detection rate of 5% of false positive of each maternal ophthalmic Doppler index and the mean uterine artery PI for prediction SGA. RESULTS: 27 (5.4%) patients delivered SGA newborns, 12 (2.4%) patients developed preeclampsia (PE) and delivered SGA newborns, and 460 had uneventful pregnancies (controls). We observed significant difference of PI and PR between SGA (SGA and SGA+PE) and control groups, p = 0.043 and p = 0.014, respectively. To 5% of false positive, the detection rate of SGA (SGA and SGA+PE groups) using PI, PD1 and PR were 14.8, 3.7, 14.8, 16.7, 16.7 and 16.7%, respectively. Mean uterine PI was significantly higher in the SGA+PE group (p = 0.003). CONCLUSION: The isolated use of maternal ophthalmic Doppler indices or in combination with uterine artery Doppler, in the first trimester of pregnancy, was not efficient to predict SGA newborns.
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