OC13.06: Prediction and prevention of small‐for‐gestational‐age neonates in an Asian population

To examine the external validity of the new Fetal Medicine Foundation (FMF) competing risk model for the prediction of small for gestational age (SGA) at 11-14 weeks of gestation in an Asian population and the effect of prophylactic use of aspirin on the prevention of SGA. This is a multicentre prospective cohort study in 42,897 women with singleton pregnancies undergoing routine assessment at 11-14 weeks of gestation. We applied the FMF competing risk model for the first trimester prediction of SGA combining maternal characteristics and medical history with measurements of mean arterial pressure (MAP), uterine artery pulsatility index (UtA-PI), and serum placental growth factor (PlGF). We obtained risks for different cut-offs of birthweight percentile. We examined the predictive performance in terms of discrimination and calibration. The predictive performance of the competing risk model for SGA was similar to that reported in the FMF study. Specifically, combining maternal factors with MAP, UtA-PI, and PlGF resulted in the best predictive performance for preterm SGA <10th percentile and <5th percentile, with area under the curves (AUCs) of 0.765 (95% confidence interval [CI], 0.720-0.809) and 0.789 (95%CI, 0.736-0.841), respectively. For predicting preterm SGA <3rd percentile, the best model was the combination of maternal factors, MAP, and PlGF with an AUC of 0.797 (95%CI, 0.744-0.850). The calibration of the new model was satisfactory. Aspirin did not have a significant effect on incidence of SGA<3th, 5th, and 10th percentile. Final results on aspirin effect on rates of SGA at <32 weeks and <37 weeks will be presented. The screening performance of the new FMF first trimester competing risk model for SGA in an independent large cohort of Asian women is comparable to that reported in the original FMF study on a mixed European population. This FMF SGA prediction model can be implemented as part of routine prenatal care by using existing healthcare infrastructure for pre-eclampsia screening.

Authors

Institutions

Publication Details

Journal
Ultrasound in Obstetrics and Gynecology
Published
2024-09-01
DOI
https://doi.org/10.1002/uog.27813
Primary Topic
Neonatal Respiratory Health Research
Type
article
Field-Weighted Citation Impact
0.00

Funders

Controls
|||
ALL TIME
JAN
FEB
MAR
APR
MAY
JUN
JUL
AUG
SEP
OCT
article

OC13.06: Prediction and prevention of small‐for‐gestational‐age neonates in an Asian population

Sara Tai, Steven W. Shaw, Kelvin Kam Lung Chong, L. Nguyen Hoang et al.
Ultrasound in Obstetrics and Gynecology
Neonatal Respiratory Health Research
article

OC13.06: Prediction and prevention of small‐for‐gestational‐age neonates in an Asian population

Sara Tai, Steven W. Shaw, Kelvin Kam Lung Chong, L. Nguyen Hoang, Miao Zheng, Noppadol Chaiyasit, Polly H. M. Leung, Ritsuko K. Pooh, Daljit Singh Sahota, Ioannis Papastefanou, Xuanzhen Lu, Yali Hu, Zaleha Abdullah Mahdy, Raden Aditya Kusuma, Tongta Nanthakomon, Suchaya Luewan, Tien‐Chun Chang, Arihiro Shiozaki, Piengbulan Yapan, Mahesh Choolani, Diem Thi Nguyen, Huan Liu, Yue Chen, Bingxue Li, Nikki Lee, L.C. Poon, WC Leung, Mayumi Tokunaka, Long Dinh, S. Lau, A.S. Aguilar
article en

Abstract

To examine the external validity of the new Fetal Medicine Foundation (FMF) competing risk model for the prediction of small for gestational age (SGA) at 11-14 weeks of gestation in an Asian population and the effect of prophylactic use of aspirin on the prevention of SGA. This is a multicentre prospective cohort study in 42,897 women with singleton pregnancies undergoing routine assessment at 11-14 weeks of gestation. We applied the FMF competing risk model for the first trimester prediction of SGA combining maternal characteristics and medical history with measurements of mean arterial pressure (MAP), uterine artery pulsatility index (UtA-PI), and serum placental growth factor (PlGF). We obtained risks for different cut-offs of birthweight percentile. We examined the predictive performance in terms of discrimination and calibration. The predictive performance of the competing risk model for SGA was similar to that reported in the FMF study. Specifically, combining maternal factors with MAP, UtA-PI, and PlGF resulted in the best predictive performance for preterm SGA <10th percentile and <5th percentile, with area under the curves (AUCs) of 0.765 (95% confidence interval [CI], 0.720-0.809) and 0.789 (95%CI, 0.736-0.841), respectively. For predicting preterm SGA <3rd percentile, the best model was the combination of maternal factors, MAP, and PlGF with an AUC of 0.797 (95%CI, 0.744-0.850). The calibration of the new model was satisfactory. Aspirin did not have a significant effect on incidence of SGA<3th, 5th, and 10th percentile. Final results on aspirin effect on rates of SGA at <32 weeks and <37 weeks will be presented. The screening performance of the new FMF first trimester competing risk model for SGA in an independent large cohort of Asian women is comparable to that reported in the original FMF study on a mixed European population. This FMF SGA prediction model can be implemented as part of routine prenatal care by using existing healthcare infrastructure for pre-eclampsia screening.

Ultrasound in Obstetrics and GynecologyVol. 64(S1)
Thammasat University (TH), SHOWA Medical University (JP), Siriraj Hospital (TH), Chinese University of Hong Kong (HK), King's College London (GB), Mahidol University (TH), Kunming Medical University (CN), Kwong Wah Hospital (CN), Toyama College (JP), King Chulalongkorn Memorial Hospital (TH), Chang Gung Memorial Hospital (TW), Hong Kong Jockey Club (HK), Guangzhou Women and Children Medical Center (CN), Nanjing Drum Tower Hospital (CN), Chinese University of Hong Kong, Shenzhen (CN), Osaka Nishi Clinic (JP), First Affiliated Hospital of Kunming Medical University (CN), Pembuluh Darah Harapan Kita (ID), Vietnam National Children's Hospital (VN), National University Hospital (SG), Viet Duc Hospital (VN), University of Toyama (JP), Chiang Mai University (TH), National University of Malaysia (MY), Guangzhou Medical University (CN)
King's College London, Chiang Mai University, Kunming Medical University, Mahidol University, Universiti Kebangsaan Malaysia, Chang Gung Medical Foundation, University of the Philippines, Nanjing University, Nanjing Drum Tower Hospital, Shenzhen Research Institute, City University of Hong Kong, Faculty of Medicine Siriraj Hospital, Mahidol University
Zero hunger
Openalex Percentile: Top 73%
Neonatal Respiratory Health Research
DOIOpen Access PDFOpenAlex
AI Navigator

Ask Laika to Summarize, Analyze, and Connect papers live on the map.

Summarize Papers & Methodologies

Extract key findings, datasets, and comparative methods across publications.

Benchmark Rankings & Visual Analytics

Rank top research institutions, authors, funders, topics, and journals by Field-Weighted Citation Impact (FWCI) and paper volume with instant charts.

Connect Distant Disciplines

Bridge topological clusters on the map to find hidden collaborative intersections.