Middle Cerebral Artery Doppler and Cerebroplacental Ratio Predict Adverse Neurological Outcomes in Fetal Growth Restriction

ABSTRACT Objective To assess the efficacy of middle cerebral artery (MCA) Doppler ultrasonography in predicting neurological and respiratory outcomes in fetuses with fetal growth restriction (FGR) and to establish a correlation between MCA Doppler and head circumference (HC). Method Retrospective cohort study examining singleton pregnancies affected by FGR (2018–2019). MCA and Cerebroplacental Ratio (CPR) Doppler indices ( z ‐scores) alongside neonatal neurological and respiratory outcomes were gathered. Results MCA (OR 0.51, 95% CI 0.32–0.82) and CPR (OR 1.36, 95% CI 1.10–1.68) were identified as significant predictors of neurological outcomes ( p < 0.05). Gestational age and CPR exhibited comparable univariate accuracy; however, the multivariate model demonstrated superior performance, achieving an area under the curve of 80.30%. Correlation analysis indicated a significant relationship between neonatal HC and MCA PI z ‐score in univariate analysis, but this was not confirmed in multivariate analysis. Conclusion MCA Doppler and CPR are effective predictors of adverse neurological outcomes in FGR, potentially aiding risk stratification in clinical practice.