Predictors of neonatal outcome in early-onset placental dysfunction
Open accessAbstract
OBJECTIVE: To identify specific estimates and predictors of neonatal morbidity and mortality in early onset fetal growth restriction due to placental dysfunction. METHODS: Prospective multicenter study of prenatally diagnosed growth-restricted liveborn neonates of less than 33 weeks of gestational age. Relationships between perinatal variables (arterial and venous Dopplers, gestational age, birth weight, acid-base status, and Apgar scores) and major neonatal complications, neonatal death, and intact survival were analyzed by logistic regression. Predictive cutoffs were determined by receiver operating characteristic curves. RESULTS: Major morbidity occurred in 35.9% of 604 neonates: bronchopulmonary dysplasia in 23.2% (n=140), intraventricular hemorrhage in 15.2% (n=92), and necrotizing enterocolitis in 12.4% (n=75). Total mortality was 21.5 % (n=130), and 58.3% survived without complication (n=352). From 24 to 32 weeks, major morbidity declined (56.6% to 10.5%), coinciding with survival that exceeded 50% after 26 weeks. Gestational age was the most significant determinant (P<.005) of total survival until 26(6/7) weeks (r(2)=0.27), and intact survival until 29(2/7) weeks (r(2)=0.42). Beyond these gestational-age cutoffs, and above birth weight of 600 g, ductus venosus Doppler and cord artery pH predicted neonatal mortality (P<.001, r(2)=0.38), and ductus venosus Doppler alone predicted intact survival (P<.001, r(2)=0.34). CONCLUSION: This study provides neonatal outcomes specific for early-onset placenta-based fetal growth restriction quantifying the impact of gestational age, birth weight, and fetal cardiovascular parameters. Early gestational age and birth weight are the primary quantifying parameters. Beyond these thresholds, ductus venosus Doppler parameters emerge as the primary cardiovascular factor in predicting neonatal outcome. LEVEL OF EVIDENCE: II.
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?
The single most important prognostic factor in preterm fetuses with growth restriction is the gestational age at delivery.
“The single most important prognostic factor in preterm fetuses with growth restriction is the gestational age at delivery.80,83”
From Society for Maternal-Fetal Medicine Consult Series #52: Diagnosis and management of fetal growth restriction (2020) · cites this paper as [83]
The Results report that gestational age was the most significant determinant of neonatal survival until 26 6/7 weeks. The claim is broader than that finding: the paper describes gestational age as a significant contributor to major morbidity until 29 2/7 weeks, and the Discussion identifies ductus venosus abnormality as an important predictor of neonatal complications beyond 27 weeks. Page numbers were not provided in our copy. (LLM, conf=0.85)
Experimental — accuracy not yet measuredA large longitudinal cohort study on fetal growth restriction showed an increase of 1%-2% in intact survival for every additional day spent in utero up until 32 weeks of gestation.
“A large longitudinal cohort study on FGR showed an increase of 1%e2% in intact survival for every additional day spent in utero up until 32 weeks of gestation.83”
From Society for Maternal-Fetal Medicine Consult Series #52: Diagnosis and management of fetal growth restriction (2020) · cites this paper as [83]
The Results report that this large study of growth-restricted fetuses found neonatal survival gains of about 2% per day in utero from 24 to 27 weeks and 1% thereafter; they also report increasing intact survival through 32 weeks. The paper does not assign those per-day percentages to intact survival, as the citing sentence does. (LLM, conf=0.88)
Experimental — accuracy not yet measuredThe pulsatility index, resistance index, or systolic-to-diastolic ratio can be used for quantification of the Doppler waveform in the umbilical artery, although recent studies have generally used either the pulsatility index or resistance index.
“The pulsatility index (PI), resistance index (RI), or systolicto-diastolic (S/D) ratio can be used for quantification of the Doppler waveform in the umbilical artery, although recent studies have generally used either the PI or RI.5,16,28,30,80,83”
From Society for Maternal-Fetal Medicine Consult Series #52: Diagnosis and management of fetal growth restriction (2020) · cites this paper as [83]
Split into 2 atoms — 0 confirmed, 0 partially supported, 0 disputed, 0 misattributed, 2 unverifiable. Expand the claim to see per-atom verdicts.
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.
Cites
Receiver-operating characteristic (ROC) plots: a fundamental evaluation tool in clinical medicine
ZWEIG, M. H., & Campbell, G. (1993) · Clinical Chemistry · doi:10.1093/clinchem/39.4.561 · Cited by 6,528 · see citing works
Papile, L. A., Burstein, J., Burstein, R., & Koffler, H. (1978) · The Journal of Pediatrics · doi:10.1016/s0022-3476(78)80282-0 · Cited by 6,435 · see citing works
Usher, R. H., & McLean, F. H. (1969) · The Journal of Pediatrics · doi:10.1016/s0022-3476(69)80224-6 · Cited by 1,260 · see citing works
Morbidity and mortality among very-low-birth-weight neonates with intrauterine growth restriction
Bernstein, I. M., Horbar, J. D., Badger, G. J., Ohlsson, A., & Golan, A. (2000) · American Journal of Obstetrics and Gynecology · doi:10.1016/s0002-9378(00)70513-8 · Cited by 840 · see citing works
Fetal umbilical artery flow velocity waveforms and placental resistance: pathological correlation
Giles, W. B., Trudinger, B., & Baird, P. J. (1985) · BJOG An International Journal of Obstetrics & Gynaecology · doi:10.1111/j.1471-0528.1985.tb01045.x · Cited by 730 · see citing works
MacLennan, R., & Jensen, O. M. (1977) · PubMed · Cited by 685 · see citing works
Monitoring of fetuses with intrauterine growth restriction: a longitudinal study
Hecher, K., Bilardo, C. M., Stigter, R. H., Ville, Y. G., Hackelöer, B.-J., Kok, H. J., Sénat, M., & Visser, G. H. A. (2001) · Ultrasound in Obstetrics and Gynecology · doi:10.1046/j.0960-7692.2001.00590.x · Cited by 492 · see citing works
Self-citationFerrazzi, E. M., Bozzo, M., Rigano, S., Bellotti, M., Morabito, A., Pardi, G., Battaglia, F. C., & Galan, H. L. (2002) · Ultrasound in Obstetrics and Gynecology · doi:10.1046/j.0960-7692.2002.00627.x · Cited by 452 · see citing works
Self-citationClinical significance of absent or reversed end diastolic velocity waveforms in umbilical artery
Karsdorp, V. H. M., van Vugt, J. M. G., van Geijn, H. P., Kostense, P. J., Arduim, D., Montenegro, N., & Todros, T. (1994) · The Lancet · doi:10.1016/s0140-6736(94)90457-x · Cited by 445 · see citing works
Assessment of Fetal Compromise by Doppler Ultrasound Investigation of the Fetal Circulation
Hecher, K., Campbell, S. C., Doyle, P., Harrington, K., & Nicolaides, K. H. (1995) · Circulation · doi:10.1161/01.cir.91.1.129 · Cited by 444 · see citing works
Self-citationIntrauterine growth restriction increases morbidity and mortality among premature neonates
Garite, T. J., Clark, R. H., & Thorp, J. A. (2004) · American Journal of Obstetrics and Gynecology · doi:10.1016/j.ajog.2004.01.036 · Cited by 443 · see citing works
Baschat, A. A., Gembruch, U., & Harman, C. R. (2001) · Ultrasound in Obstetrics & Gynecology · doi:10.1046/j.0960-7692.2001.00591.x · Cited by 435 · see citing works
Self-citationRelationship between arterial and venous Doppler and perinatal outcome in fetal growth restriction
Baschat, A., Gembruch, U., Reiss, I. K. M., Gortner, L., Weiner, C. P., & Harman, C. R. (2000) · Ultrasound in Obstetrics and Gynecology · doi:10.1046/j.1469-0705.2000.00284.x · Cited by 285 · see citing works
Self-citationBilardo, C. M., Wolf, H., Stigter, R. H., Ville, Y. G., Baez, E., Visser, G. H. A., & Hecher, K. (2004) · Ultrasound in Obstetrics and Gynecology · doi:10.1002/uog.965 · Cited by 277 · see citing works
Self-citation(2002) · BJOG An International Journal of Obstetrics & Gynaecology · doi:10.1016/s1470-0328(02)02514-4 · Cited by 248 · see citing works
Fetal growth and adult disease
Barker, D. J. (1992) · BJOG An International Journal of Obstetrics & Gynaecology · doi:10.1111/j.1471-0528.1992.tb13719.x · Cited by 235 · see citing works
Zeitlin, J. A., Ancel, P., Saurel‐Cubizolles, M., & Papiernik, E. (2000) · BJOG An International Journal of Obstetrics & Gynaecology · doi:10.1111/j.1471-0528.2000.tb13336.x · Cited by 212 · see citing works
Bellotti, M., Pennati, G., de Gasperi, C., Bozzo, M., Battaglia, F. C., & Ferrazzi, E. M. (2004) · American Journal of Obstetrics and Gynecology · doi:10.1016/j.ajog.2003.11.018 · Cited by 194 · see citing works
Self-citationRANDOMISED CONTROLLED TRIAL OF ULTRASONOGRAPHIC SCREENING IN PREGNANCY
Bakketeig, L., Jacobsen, G. W., Brodtkorb, C., Eriksen, B., Eik-Nes, S., Ulstein, M., Balstad, P., & Jørgensen, N. F. (1984) · The Lancet · doi:10.1016/s0140-6736(84)90492-6 · Cited by 189 · see citing works
Doppler, Cardiotocography, and Biophysical Profile Changes in Growth-Restricted Fetuses
Cosmi, E., Ambrosini, G., D’Antona, D., Saccardi, C., & Mari, G. (2005) · Obstetrics and Gynecology · doi:10.1097/01.aog.0000187540.37795.3a · Cited by 156 · see citing works
Self-citationBaschat, A. A., & Weiner, C. P. (2000) · American Journal of Obstetrics and Gynecology · doi:10.1016/s0002-9378(00)70505-9 · Cited by 151 · see citing works
Self-citationDoppler and biophysical assessment in growth restricted fetuses: distribution of test results
Baschat, A., Galan, H. L., Bhide, A., Berg, C., Kush, M. L., Oepkes, D., Thilaganathan, B., Gembruch, U., & Harman, C. R. (2005) · Ultrasound in Obstetrics and Gynecology · doi:10.1002/uog.2657 · Cited by 137 · see citing works
Self-citationBaschat, A. (2003) · Ultrasound in Obstetrics and Gynecology · doi:10.1002/uog.21 · Cited by 104 · see citing works
Self-citationClinical management of the fetus with markedly diminished umbilical artery end-diastolic flow
Divon, M. Y., Girz, B. A., Lieblich, R., & Langer, O. (1989) · American Journal of Obstetrics and Gynecology · doi:10.1016/0002-9378(89)90917-4 · Cited by 98 · see citing works
"Normal" Umbilical Arterial and Venous Acid-Base and Blood Gas Values
Gregg, A. R., & Weiner, C. P. (1993) · Clinical Obstetrics & Gynecology · doi:10.1097/00003081-199303000-00006 · Cited by 75 · see citing works
Foetal nutrition, foetal growth restriction and health later in life
Henriksen, T. (1999) · Acta Paediatrica · doi:10.1111/j.1651-2227.1999.tb01284.x · Cited by 54 · see citing works
Lees, C. C., & BAUMGARTNER, H. (2005) · Ultrasound in Obstetrics and Gynecology · doi:10.1002/uog.1836 · Cited by 49 · see citing works
Flagged first, then by citations
Research works printed but not linked: 2
- [23]23. Bakketeig LS, Jacobsen G, Brodtkorb CJ, Eik-Nes S, Ulstein MK, Balstad P, et al. Randomized controlled trial of ultrasono- graphic screening in pregnancy. Lancet 1984;2:207-11.
- [24]24. Harman CR. Antenatal assessment of fetal status. In: Creasy R, Iams J, Resnik R, editors. Maternal-fetal medicine. 5th ed. Philadelphia (PA): WB Saunders; 2004. p. 357-400.
Cited by
Sorted by citations
2018 ESC Guidelines for the management of cardiovascular diseases during pregnancy
Regitz-Zagrosek, V., Roos-Hesselink, J. W., Bauersachs, J., Blomström-Lundqvist, C., Cífková, R., De Bonis, M., Iung, B., Johnson, M. R., Kintscher, U., Kranke, P., et al. (2018) · European Heart Journal · doi:10.1093/eurheartj/ehy340 · Cited by 2,292 · see citing works
ESC Guidelines on the management of cardiovascular diseases during pregnancy
Endorsed by the European Society of Gynecology (ESG), T. A. F. E. P. C. (., Authors/Task Force Members, Regitz-Zagrosek, V., Blomstrom Lundqvist, C., Borghi, C., Cifkova, R., Ferreira, R., Foidart, J.-M., Gibbs, J. S. R., Gohlke-Baerwolf, C., et al. (2011) · European Heart Journal · doi:10.1093/eurheartj/ehr218 · Cited by 1,924 · see citing works
Lees, C. C., Stampalija, T., Baschat, A. A., da Silva Costa, F., Ferrazzi, E., Figueras, F., Hecher, K., Kingdom, J., Poon, L. C., Salomon, L. J., et al. (2020) · Ultrasound in Obstetrics & Gynecology · doi:10.1002/uog.22134 · Cited by 886 · see citing works
Self-citationMartins, J. G., Biggio, J. R., & Abuhamad, A. (2020) · American Journal of Obstetrics and Gynecology · doi:10.1016/j.ajog.2020.05.010 · Cited by 549 · see citing works
Lees, C., Marlow, N., Arabin, B., Bilardo, C. M., Brezinka, C., Derks, J. B., Duvekot, J., Frusca, T., Diemert, A., Ferrazzi, E., et al. (2013) · Ultrasound in Obstetrics & Gynecology · doi:10.1002/uog.13190 · Cited by 540 · see citing works
Self-citationIntrauterine growth restriction: new concepts in antenatal surveillance, diagnosis, and management
Figueras, F., & Gardosi, J. (2011) · American Journal of Obstetrics and Gynecology · doi:10.1016/j.ajog.2010.08.055 · Cited by 485 · see citing works
Lees, C. C., Marlow, N., van Wassenaer-Leemhuis, A., Arabin, B., Bilardo, C. M., Brezinka, C., Calvert, S., Derks, J. B., Diemert, A., Duvekot, J. J., et al. (2015) · The Lancet · doi:10.1016/s0140-6736(14)62049-3 · Cited by 479 · see citing works
Self-citationCrispi, F., Miranda, J., & Gratacós, E. (2018) · American Journal of Obstetrics and Gynecology · doi:10.1016/j.ajog.2017.12.012 · Cited by 362 · see citing works
Progression of Doppler abnormalities in intrauterine growth restriction
Turan, O. M., Turan, S., Gungor, S., Berg, C., Moyano, D., Gembruch, U., Nicolaides, K. H., Harman, C. R., & Baschat, A. A. (2008) · Ultrasound in Obstetrics & Gynecology · doi:10.1002/uog.5386 · Cited by 353 · see citing works
Self-citationSavchev, S., Figueras, F., Sanz-Cortes, M., Cruz-Lemini, M., Triunfo, S., Botet, F., & Gratacos, E. (2014) · Fetal Diagnosis and Therapy · doi:10.1159/000355525 · Cited by 182 · see citing works
Diagnosis and management of fetal growth restriction
Bamfo, J. E. A. K., & Odibo, A. O. (2011) · Journal of Pregnancy · doi:10.1155/2011/640715 · Cited by 178 · see citing works
Unterscheider, J., O’Donoghue, K., Daly, S., Geary, M. P., Kennelly, M. M., McAuliffe, F. M., Hunter, A., Morrison, J. J., Burke, G., Dicker, P., et al. (2014) · BMC Pregnancy and Childbirth · doi:10.1186/1471-2393-14-63 · Cited by 172 · see citing works
Yagel, S., Kivilevitch, Z., Cohen, S. M., Valsky, D. V., Messing, B., Shen, O., & Achiron, R. (2010) · Ultrasound in Obstetrics & Gynecology · doi:10.1002/uog.7622 · Cited by 129 · see citing works
Caradeux, J., Martinez-Portilla, R. J., Basuki, T. R., Kiserud, T., & Figueras, F. (2018) · American Journal of Obstetrics and Gynecology · doi:10.1016/j.ajog.2017.11.566 · Cited by 115 · see citing works
Early onset fetal growth restriction
Dall’Asta, A., Brunelli, V., Prefumo, F., Frusca, T., & Lees, C. C. (2017) · Maternal Health, Neonatology and Perinatology · doi:10.1186/s40748-016-0041-x · Cited by 110 · see citing works
Burton, G. J., Scioscia, M., & Rademacher, T. W. (2011) · Journal of Reproductive Immunology · doi:10.1016/j.jri.2011.02.005 · Cited by 64 · see citing works
Visser, G. H. A., Bilardo, C. M., Derks, J. B., Ferrazzi, E., Fratelli, N., Frusca, T., Ganzevoort, W., Lees, C. C., Napolitano, R., Todros, T., et al. (2017) · Ultrasound in Obstetrics & Gynecology · doi:10.1002/uog.17361 · Cited by 51 · see citing works
Self-citationReus, A. D., El-Harbachi, H., Rousian, M., Willemsen, S. P., Steegers-Theunissen, R. P. M., Steegers, E. A. P., & Exalto, N. (2013) · Ultrasound in Obstetrics & Gynecology · doi:10.1002/uog.13197 · Cited by 46 · see citing works
The role of the fetal biophysical profile in the management of fetal growth restriction
Baschat, A. A., Galan, H. L., Lee, W., DeVore, G. R., Mari, G., Hobbins, J., Vintzileos, A., Platt, L. D., & Manning, F. A. (2022) · American Journal of Obstetrics and Gynecology · doi:10.1016/j.ajog.2022.01.020 · Cited by 42 · see citing works
Self-citationFetal growth restriction at the limits of viability
Visser, G. H. A., Bilardo, C. M., & Lees, C. (2014) · Fetal Diagnosis and Therapy · doi:10.1159/000358058 · Cited by 32 · see citing works
Self-citation
- Authors
- Baschat, A. A., Cosmi, E., Bilardo, C. M., Wolf, H., Berg, C., Rigano, S., Germer, U., Moyano, D., Turan, S., Hartung, J., Bhide, A., Müller, T., Bower, S., Nicolaides, K. H., Thilaganathan, B., Gembruch, U., Ferrazzi, E., Hecher, K., Galan, H. L., & Harman, C. R.
- Affiliations
- University of Maryland, Baltimore (US)
- ORCID
- Venue
- Obstetrics & Gynecology
- Published
- 2007-02
- Volume
- 109
- Issue
- 2, Part 1
- Pages
- 253-261
- ISSN
- 0029-7844 (ISSN-L)
- OpenAlex
- W2061764094
- Semantic Scholar
- ec3e2be5eabc30f3cc2cee6688931d53ed126dd3
- Cited by
- 485
- References
- 28
- Citations by year
- 2026: 12 · 2025: 12 · 2024: 10 · 2023: 27 · 2022: 21 · 2021: 27 · 2020: 15 · 2019: 19 · 2018: 37 · 2017: 26 · 2016: 26 · 2015: 24 · 2014: 36 · 2013: 30 · 2012: 28
- FWCI
- 37.81
- Type
- journal article
- Language
- en
- Open access
- green
- hdl.handle.net
- Licence
- other-oa
- Locations
- Obstetrics and Gynecology (publishedVersion)
- PubMed (publishedVersion)
- Padua Research Archive (University of Padova) (submittedVersion, other-oa)
- Data Archiving and Networked Services (DANS) (submittedVersion)
- Research Portal (King's College London) (submittedVersion)
- Pure Amsterdam UMC (submittedVersion)
- Topics
- Health Sciences › Medicine › Obstetrics and Gynecology › Pregnancy and preeclampsia studies
- Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Neonatal and fetal brain pathology
- Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Infant Development and Preterm Care
- Keywords
- fetal growth restriction, neonatal outcomes, neonatal mortality, neonatal morbidity, gestational age, birth weight, ductus venosus Doppler, cordocentesis, fetal acid-base status, bronchopulmonary dysplasia, intraventricular hemorrhage, necrotizing enterocolitis, neonatal survival, preterm infants
- MeSH terms
- Adolescent, Adult, Birth Weight, Female, Fetal Growth Retardation, Gestational Age, Humans, Infant, Newborn, Infant, Premature, Infant, Premature, Diseases, Placental Insufficiency, Predictive Value of Tests, Pregnancy, Umbilical Cord, Cohort Studies, Ultrasonography, Prenatal, Placental Circulation
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
