Role of early second-trimester uterine artery Doppler screening to predict small-for-gestational-age babies in nulliparous women
Open accessAbstract
BACKGROUND: Trophoblastic invasion of the uterine spiral arteries substantially increases compliance to accommodate increased blood flow to the placenta. Failure of this process impedes uterine artery blood flow, and this may be detected by uterine artery Doppler flow studies. However, the clinical utility of uterine artery Doppler flow studies in the prediction of adverse pregnancy outcomes in a general population remains largely unknown. OBJECTIVE: We sought to determine the utility of early second‐trimester uterine artery Doppler studies as a predictor of small‐for‐gestational‐age neonates. STUDY DESIGN: Nulliparous women with a viable singleton pregnancy were recruited during their first trimester into an observational prospective cohort study at 8 institutions across the United States. Participants were seen at 3 study visits during pregnancy and again at delivery. Three indices of uterine artery Doppler flow (resistance index, pulsatility index, and diastolic notching) were measured in the right and left uterine arteries between 16 weeks 0 days' and 22 weeks 6 days' gestation. Test characteristics for varying thresholds in the prediction of small for gestational age (defined as birthweight <5th percentile for gestational age [Alexander growth curve]) were evaluated. RESULTS: Uterine artery Doppler indices, birthweight, and gestational age at birth were available for 8024 women. Birthweight <5th percentile for gestational age occurred in 358 (4.5%) births. Typical thresholds for the uterine artery Doppler indices were all associated with birthweight <5th percentile for gestational age (P < .0001 for each), but the positive predictive values for these cutoffs were all <15% and areas under receiver operating characteristic curves ranged from 0.50‐0.60. Across the continuous scales for these measures, the areas under receiver operating characteristic curves ranged from 0.56‐0.62. Incorporating maternal age, early pregnancy body mass index, race/ethnicity, smoking status prior to pregnancy, chronic hypertension, and pregestational diabetes in the prediction model resulted in only modest improvements in the areas under receiver operating characteristic curves ranging from 0.63‐0.66. CONCLUSION: In this large prospective cohort, early second‐trimester uterine artery Doppler studies were not a clinically useful test for predicting small‐for‐gestational‐age babies.
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
Uterine artery Doppler has limited diagnostic accuracy and clinical utility in predicting FGR, SGA birth, and perinatal mortality.
“However, uterine artery Doppler has limited diagnostic accuracy and clinical utility in predicting FGR, SGA birth, and perinatal mortality.148,149”
From Society for Maternal-Fetal Medicine Consult Series #52: Diagnosis and management of fetal growth restriction (2020) · cites this paper as [149]
The Comment reports a systematic review finding limited diagnostic accuracy for fetal growth restriction and perinatal death. It also reports low predictive and clinical utility for SGA and stillbirth in this study’s cohort of unselected nulliparous women screened in the early second trimester. The claim omits that population and timing limitation and extends the clinical-utility finding to FGR and perinatal mortality, which this study did not directly assess as such. (LLM, conf=0.84)
Experimental — accuracy not yet measured
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
The self-check needs the paper’s full text.
The citation lists haven’t been fetched yet
References 25 · Cited by 66
- Authors
- Parry, S., Sciscione, A., Haas, D. M., Grobman, W. A., Iams, J. D., Mercer, B. M., Silver, R. M., Simhan, H. N., Wapner, R. J., Wing, D. A., Elovitz, M. A., Schubert, F. P., Peaceman, A., Esplin, M. S., Caritis, S., Nageotte, M. P., Carper, B. A., Saade, G. R., Reddy, U. M., & Parker, C. B.
- Affiliations
- University of Pennsylvania (US)
- Christiana Care Health System (US)
- Indiana University School of Medicine (US)
- Northwestern University (US)
- The Ohio State University (US)
- Case Western Reserve University (US)
- University of Utah (US)
- University of Pittsburgh (US)
- Columbia University (US)
- University of California, Irvine (US)
- RTI International (US)
- The University of Texas Medical Branch at Galveston (US)
- National Institutes of Health (US)
- Corresponding author
- Parry, Samuel
- ORCID
- Venue
- American Journal of Obstetrics and Gynecology
- Publisher
- Elsevier BV
- Published
- 2017-11
- Volume
- 217
- Issue
- 5
- Pages
- 594.e1-594.e10
- ISSN
- 0002-9378 (ISSN-L)
- PMC
- PMC5671346
- OpenAlex
- W2735424569
- Semantic Scholar
- 4a6fb4fccbb04c6d867fb53708cd074c0faaddb4
- Cited by
- 66
- References
- 25
- Citations by year
- 2026: 3 · 2025: 5 · 2024: 9 · 2023: 11 · 2022: 7 · 2021: 8 · 2020: 7 · 2019: 7 · 2018: 8 · 2017: 1
- FWCI
- 7.41
- Type
- journal article
- Language
- en
- Open access
- green
- europepmc.org
- Locations
- American Journal of Obstetrics and Gynecology (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- IUScholarWorks (Indiana University) (submittedVersion)
- Purdue University Indianapolis (Indiana University) (submittedVersion)
- Funders
- Columbia University (U10 HD063037)
- University of Utah
- University of California, Irvine (U10 HD063048)
- Northwestern University (U10 HD063046)
- Indiana University (U10 HD063041)
- Case Western Reserve University (U10 HD063047)
- University of Pittsburgh (U10 HD063020)
- University of Pennsylvania (U10 HD063053)
- Eunice Kennedy Shriver National Institute of Child Health and Human Development (U10 HD063036, U10 HD063072)
- Topics
- Health Sciences › Medicine › Obstetrics and Gynecology › Pregnancy and preeclampsia studies
- Health Sciences › Medicine › Obstetrics and Gynecology › Maternal and Perinatal Health Interventions
- Health Sciences › Medicine › Obstetrics and Gynecology › Gestational Diabetes Research and Management
- Keywords
- uterine artery Doppler, small for gestational age, second-trimester screening, nulliparous women, resistance index, pulsatility index, birth weight prediction, adverse pregnancy outcome prediction, trophoblast invasion, uteroplacental blood flow
- MeSH terms
- Adolescent, Adult, Birth Weight, Female, Gestational Age, Humans, Infant, Newborn, Infant, Small for Gestational Age, Parity, Pregnancy, Pregnancy Outcome, Pregnancy Trimester, Second, Prospective Studies, Pulsatile Flow, Vascular Resistance, Cohort Studies, Ultrasonography, Prenatal, Ultrasonography, Doppler, Young Adult, Uterine Artery
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
