First-trimester placental ultrasound and maternal serum markers as predictors of small-for-gestational-age infants
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Objective The objective of the study was to combine early, direct assessment of the placenta with indirect markers of placental development to identify pregnancies at greatest risk of delivering small-for-gestational age infants (SGA10).Study design We prospectively collected 3-dimensional ultrasound volume sets, uterine artery pulsatility index, and maternal serum of singleton pregnancies at 11-14 weeks. Placental volume (PV), quotient (placental quotient [PQ] = PV/gestational age), mean placental diameter (MPD) and chorionic diameters, and the placental morphology index (PMI = MPD/PQ and adjusts the lateral placental dimensions for quotient) were measured offline. Maternal serum was assayed for placental growth factor and placental protein-13. These variables were evaluated as predictors of SGA10.Results Of the 578 pregnancies included in the study, 56 (9.7%) delivered SGA10. SGA10 pregnancies had a significantly smaller PV, PQ, MPD, and mean placental diameter and higher PMI compared with normal pregnancies (P < .001 for each). Each placental measure remained significantly associated with SGA10 after adjusting for confounders and significantly improved the performance of the model using clinical variables alone (P < .04 for each) with adjusted areas under the curve ranging from 0.71 to 0.74. Uterine artery pulsatility index did not remain significantly associated with SGA10 after adjusting for confounders (P = .06). Placental growth factor was significantly lower in SGA10 pregnancies (P = .02) and remained significant in adjusted models but failed to significantly improve the predictive performance of the models as measured by area under the curve (P > .3). Placental protein-13 was not associated with SGA10 (P = .99).Conclusion Direct assessment of placental size and shape with 3-dimensional ultrasound can serve as the foundation upon which to build a multivariable model for the early prediction of SGA.
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First trimester placental volume is associated with adverse pregnancy outcomes, including small-for-gestational-age infants born under the 10th or 5th centiles.
“Early placental volume (PV) has been associated with small-for-gestational-age infants born under the 10th/5th centiles (SGA10/SGA5).”
From Fully Automated Placental Volume Quantification From<scp>3D</scp>Ultrasound for Prediction of Small‐for‐Gestational‐Age Infants (2022) · cites this paper as [9]
Volume data sets from the cohort were previously analyzed using the VOCAL semi-automated segmentation method and found to be significantly associated with SGA.
“Volume data sets were previously analyzed using VOCAL semi-automated segmentation method and found to be significantly associated with SGA.”
From Fully Automated Placental Volume Quantification From<scp>3D</scp>Ultrasound for Prediction of Small‐for‐Gestational‐Age Infants (2022) · cites this paper as [9]
A manual quality control round was performed to eliminate 62 extremely poor images from the initial study cohort while building the train, test and SGA datasets.
“we performed a manual quality control round to eliminate 62 extremely poor images from our initial study cohort [9], while building the train, test and SGA datasets.”
From Fully Automated Placental Volume Quantification From<scp>3D</scp>Ultrasound for Prediction of Small‐for‐Gestational‐Age Infants (2022) · cites this paper as [9]
Two-dimensional and three-dimensional ultrasound have been used to study in utero placental size and morphology early in pregnancy in relation to birthweight and preeclampsia.
“In particular, two-dimensional and three-dimensional ultrasound (3DUS) have been used to study in utero placental size and morphology early in pregnancy in relation to birthweight 4 and preeclampsia. 5,6”
From Minimally interactive placenta segmentation from three-dimensional ultrasound images (2020) · cites this paper as [5]
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- Authors
- Schwartz, N., Sammel, M. D., Leite, R., & Parry, S.
- Affiliations
- University of Pennsylvania (US)
- Venue
- American Journal of Obstetrics and Gynecology
- Publisher
- Elsevier BV
- Published
- 2014-09
- Volume
- 211
- Issue
- 3
- Pages
- 253.e1-253.e8
- ISSN
- 0002-9378 (ISSN-L)
- PMC
- PMC4149853
- OpenAlex
- W2132471258
- Cited by
- 80
- References
- 52
- Citations by year
- 2026: 5 · 2025: 7 · 2024: 10 · 2023: 7 · 2022: 6 · 2021: 4 · 2020: 6 · 2019: 8 · 2018: 7 · 2017: 10 · 2016: 7 · 2015: 1 · 2014: 2
- FWCI
- 7.08
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- American Journal of Obstetrics and Gynecology (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- Eunice Kennedy Shriver National Institute of Child Health and Human Development (R03HD069742)
- Topics
- Health Sciences › Medicine › Obstetrics and Gynecology › Pregnancy and preeclampsia studies
- Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Prenatal Screening and Diagnostics
- Health Sciences › Medicine › Obstetrics and Gynecology › Gestational Diabetes Research and Management
- Keywords
- small for gestational age, placental ultrasound, placental volume, placental growth factor, placental protein 13, uterine artery pulsatility index, maternal serum biomarkers, 3-dimensional ultrasound, first-trimester prediction, singleton pregnancy
- MeSH terms
- Placenta Growth Factor, Adult, Female, Humans, Infant, Small for Gestational Age, Placenta, Pregnancy, Pregnancy Proteins, Pregnancy Trimester, First, Prospective Studies, Cohort Studies, Biomarkers, Ultrasonography, Prenatal, Area Under Curve, Uterine Artery
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