Journal of International Obstetrics and Gynecology ›› 2018, Vol. 45 ›› Issue (6): 696-699.

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Risk Assessment and Prediction of Combined Screening for Fetal Growth Restriction in Early and Mid Pregnancy

ZHONG Hai-yan,LUO Wen-bin,WANG Dong-ju,XIAO Xiao-min   

  1. Department of Gynecology and Obstetrics,Jinan University First Affiliated Hospital,Guangzhou 510630,China
  • Received:2018-05-22 Revised:2018-08-26 Published:2018-12-15 Online:2018-12-15
  • Contact: XIAO Xiao-min,E-mail:xiaoseminar@163.com E-mail:978828610@qq.com

Abstract: Objective:To establish a mathematical model through early and middle pregnancy, and to explore the value of different models for risk assessment and prediction of fetal growth restriction (FGR). Methods:2 621 cases of pregnant women were selected from January 2010 to December 2015 at the First Affiliated Hospital of Jinan University, which were combinated prenatal ultrasound screening in early and middle stage of pregnancy. Forty-nine cases(1.87%) were finally diagnosed as FGR. The age of pregnant women, pre-pregnancy body mass index (BMI), nuchal translucency (NT), free human beta chorionic gonadotropin (β-hCG), pregnancy related protein A (PAPP-A), pulsation index value of uterine artery (UtA PI) and middle cerebral artery pressure (MAP) were collected at the early stage of pregnancy. In the mid-term screening, biparietal diameter (BPD), head circumference (HC), abdominal circumference (AC) and femur length (FL) were screened. At the same time, NT, UtA PI, MAP, BPD, HC, AC and FL were expressed by the median multiplier (MoM). Group A include all original parameters. Group B include them but β-hCG, PAPP-A, UtA PI and MAP were represented by MOM. Group C include them but β-hCG, PAPP-A, UtA PI, MAP, NT, BPD, HC, AC and FL were represented by MOM. The stepwise regression analysis method were used to establish the prediction model of FGR. Reciever operating characteristic curve (ROC) analysis was conducted to compare the sensitivity and specificity of the models. Results:The results of ROC curve calculation showed that area under the curve (AUC) of three groups of regression models were 0.69 (95%CI: 0.61-0.76), 0.69 (95%CI: 0.61-0.77), 0.71 (95%CI: 0.64-0.78), respectively, and under the condition of 5% false positive rate, the detection rates were 12.26%, 14.29%, 16.32%, respectively, and the sensitivity was 10.2%, 10.2%, 16.3%, respectively. The specificity was 97.3%, 97.2% and 96.8%, respectively. Conclusions:MOM value can improve the detection rate of FGR combined prediction in early and mid pregnancy screening.

Key words: Fetal growth retardation, Pregnancy trimester, first, Pregnancy trimester, second, Logistic models