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. 2023 Jul 28;59(8):1385.
doi: 10.3390/medicina59081385.

Cerebroplacental versus Umbilicocerebral Ratio-Analyzing the Predictive Value Regarding Adverse Perinatal Outcomes in Low- and High-Risk Fetuses at Term

Florian M Stumpfe  1 , Andreas Mayr  2 , Michael O Schneider  1 , Sven Kehl  1 , Frederik Stübs  1 , Sophia Antoniadis  1 , Adriana Titzmann  1 , Constanza A Pontones  1 , Christian M Bayer  3 , Matthias W Beckmann  1 , Florian Faschingbauer  1
Affiliations

Cerebroplacental versus Umbilicocerebral Ratio-Analyzing the Predictive Value Regarding Adverse Perinatal Outcomes in Low- and High-Risk Fetuses at Term

Florian M Stumpfe et al. Medicina (Kaunas). .

Abstract

Background and Objectives: The aim of this study was to investigate the prediction of adverse perinatal outcomes using the cerebroplacental (CPR) and umbilicocerebral (UCR) ratios in different cohorts of singleton pregnancies. Materials and Methods: In this retrospective cohort study, we established our own Multiple of Median (MoM) for CPR and UCR. The predictive value for both ratios was studied in the following outcome parameters: emergency cesarean delivery, operative intervention (OI), OI due to fetal distress, 5-min Apgar < 7, admission to neonatal intensive care unit, and composite adverse perinatal outcome. The performance of the ratios was assessed in the following cohorts: total cohort (delivery ≥ 37 + 0 weeks gestation, all birth weight centiles), low-risk cohort (delivery ≥ 37 + 0 weeks gestation, birth weight ≥ 10. centile), prolonged pregnancy cohort (delivery ≥ 41 + 0 weeks gestation, birth weight ≥ 10. centile) and small-for-gestational-age fetuses (delivery ≥ 37 + 0 weeks gestation, birth weight < 10. centile). The underlying reference values for MoM were estimated using quantile regression depending on gestational age. Prediction performance was evaluated using logistic regression models assessing the corresponding Brier score, combining discriminatory power and calibration. Results: Overall, 3326 cases were included. Across all cohorts, in the case of a significant association between a studied outcome parameter and CPR, there was an association with UCR, respectively. The Brier score showed only minimal differences for both ratios. Conclusions: Our study provides further evidence regarding predictive values of CPR and UCR. The results of our study suggest that reversal of CPR to UCR does not improve the prediction of adverse perinatal outcomes.

Keywords: CPR; UCR; cerebroplacental ratio; umbilicocerebral ratio.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Study cohorts. n number wks, weeks’ gestation; CD, cesarean delivery.
Figure 2
Figure 2
ROC curves for outcome parameters in the total cohort. (a) Emergency cesarean; (b) operative intervention; (c) operative intervention due to fetal distress; (d) 5-min Apgar < 7; (e) NICU admission; and (f) CAPO.
Figure 3
Figure 3
ROC curves for outcome parameters in the low-risk cohort. (a) Emergency cesarean; (b) operative intervention; (c) operative intervention due to fetal distress; (d) 5-min Apgar < 7. (e) NICU admission; and (f) CAPO.
Figure 4
Figure 4
ROC curves for outcome parameters in the prolonged pregnancy cohort. (a) Emergency cesarean; (b) operative intervention; (c) operative intervention due to fetal distress; (d) 5-min Apgar < 7; (e) NICU admission; and (f) CAPO.
Figure 5
Figure 5
ROC curves for outcome parameters in the SGA cohort. (a) Emergency cesarean; (b) operative intervention; (c) operative intervention due to fetal distress; (d) 5-min Apgar < 7; (e) NICU admission; and (f) CAPO.
See this image and copyright information in PMC

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