First-trimester screening model for fetal growth restriction using maternal clinical characteristics, serum screening marker, and placental volume = First-trimester screening model for fetal growth restriction using maternal clinical characteristics, serum screening marker, and placental volume

다국어 초록 (Multilingual Abstract)

Objective: To demonstrate the prediction potential value of first-trimester placental volume and maternal clinical characteristics, and serum screening biomarker for fetal growth restriction (FGR) in singleton pregnancy.
Methods: Between November 2016 and May 2018, this was a prospective case-control study of pregnancies which enrolled at Bundang CHA medical center. There were 268 pregnancies without FGR and 83 pregnancies with FGR. Maternal serum pregnancy-associated plasma protein A (PAPP-A) and estimated placental volume were determined at 10+0 to 13+0 weeks and we reviewed ultrasound findings which were enrolled. We measured the width, height, and thickness of the placenta and calculated the placental volume using the established mathematical calculation method. We evaluated the associations with FGR in the first trimester based on estimated placental volume (EPV), maternal clinical characteristics and serum biomarkers by using multiple logistic regression analysis.
Results: We found that the mean placental volume was not significantly different (295.25g without FGR and 328.05g with FGR, p-value: 0.9531) between two groups. However, the PAPP-A MoM showed lower level in the women with FGR than women without FGR (0.81[0.18-2.18], 1.03 [0.17-3.01] p-value: 0.0062, respectively). The prediction model of FGR using combined EPV, maternal age, history of smoking and PAPP-A was achieving an area under the curve of 0.67 overall.
Conclusion: A risk prediction of FGR model with maternal clinical characteristics, PAPP-A and EPVcan be adopted for the first-trimester screening of FGR in singleton pregnancy.