Objective Preterm birth is among the top causes of death in infants worldwide. Premature infants are at greater risk for short and long term complications, including disabilities and impediments in growth and mental development. The correlation between premature delivery and impaired fetal growth is now supported by numerous scientific evidences that led to the hypothesis that premature birth can be a fetal adaptive response to an adverse environment. Purpose of this study was to assess whether in physiological (o normal?) pregnancies fetal weight estimated by ultrasound may be predictive of preterm delivery. Methods Case-control study (1:12 ratio). It was enrolled a group of 4498 pregnant women with normal pregnancy of 4498 physiological pregnancies of which 346 with premature birth (<37 weeks) and 4152 with delivery at term (control group). Inclusion criteria: singleton pregnancy, certain dating of pregnancy, spontaneous delivery. They have been excluded all complicated pregnancies (Intrauterine growth restriction, malformations, pre-pregnancy maternal diseases or induced pregnancies). A fetal routinary biometry was recorded and estimated fetal weight (EFW) was calculated (FWI, ESAOTE Biomedica). Each EFW was converted into Multiples of Median for each GA. Comparing the two populations of fetuses born spontaneously at term and preterm, by ROC curve analysis, a cut-off reference was identified (0.90 MoM). Results EFW was significantly lower in preterm born fetuses compared with term births (p < 0.0001). At the cut-off of 0.90 MoM EFW, as predictor of preterm delivery, achieved a sensitivity of 51.2% a specificity of 82.9%, LR+ e LR- respectively of 2.98 and 0.59. In the studied population the pre-test probability of preterm delivery was 7.7%: after applying the test, the probability of incurring in prematurity (PPV) rose to 19.9%, while the predictive value of negative test was 95.2%. Conclusion Preterm fetuses have a lower EFW than controls: at the cut-off of 0.90 MoM ultrasound estimation of fetal weight allows to identify with good specificity, the group of fetuses at increased risk of premature birth, but above all, patients at low risk of developing the disease.

Azzolini, E., Furia, G., Pistorius, L., Nante, N., Ricciardi, W. (2014). Reducing inequalities from the beginning: estimated fetal weight in preterm fetuses. EUROPEAN JOURNAL OF PUBLIC HEALTH, 24, 299-300 [10.1093/eurpub/cku165.153].

Reducing inequalities from the beginning: estimated fetal weight in preterm fetuses

NANTE, N.;
2014-01-01

Abstract

Objective Preterm birth is among the top causes of death in infants worldwide. Premature infants are at greater risk for short and long term complications, including disabilities and impediments in growth and mental development. The correlation between premature delivery and impaired fetal growth is now supported by numerous scientific evidences that led to the hypothesis that premature birth can be a fetal adaptive response to an adverse environment. Purpose of this study was to assess whether in physiological (o normal?) pregnancies fetal weight estimated by ultrasound may be predictive of preterm delivery. Methods Case-control study (1:12 ratio). It was enrolled a group of 4498 pregnant women with normal pregnancy of 4498 physiological pregnancies of which 346 with premature birth (<37 weeks) and 4152 with delivery at term (control group). Inclusion criteria: singleton pregnancy, certain dating of pregnancy, spontaneous delivery. They have been excluded all complicated pregnancies (Intrauterine growth restriction, malformations, pre-pregnancy maternal diseases or induced pregnancies). A fetal routinary biometry was recorded and estimated fetal weight (EFW) was calculated (FWI, ESAOTE Biomedica). Each EFW was converted into Multiples of Median for each GA. Comparing the two populations of fetuses born spontaneously at term and preterm, by ROC curve analysis, a cut-off reference was identified (0.90 MoM). Results EFW was significantly lower in preterm born fetuses compared with term births (p < 0.0001). At the cut-off of 0.90 MoM EFW, as predictor of preterm delivery, achieved a sensitivity of 51.2% a specificity of 82.9%, LR+ e LR- respectively of 2.98 and 0.59. In the studied population the pre-test probability of preterm delivery was 7.7%: after applying the test, the probability of incurring in prematurity (PPV) rose to 19.9%, while the predictive value of negative test was 95.2%. Conclusion Preterm fetuses have a lower EFW than controls: at the cut-off of 0.90 MoM ultrasound estimation of fetal weight allows to identify with good specificity, the group of fetuses at increased risk of premature birth, but above all, patients at low risk of developing the disease.
2014
Azzolini, E., Furia, G., Pistorius, L., Nante, N., Ricciardi, W. (2014). Reducing inequalities from the beginning: estimated fetal weight in preterm fetuses. EUROPEAN JOURNAL OF PUBLIC HEALTH, 24, 299-300 [10.1093/eurpub/cku165.153].
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11365/48718
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