OC13.06: Prediction and prevention of small‐for‐gestational‐age neonates in an Asian population
Year: 2024
Type: conference-abstract
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 <5 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 <3 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<3, 5, and 10 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.
DOI: 10.1002/uog.27813
Authors: Y. Chen, I. Papastefanou, L. Nguyen Hoang, L.T. Dinh, S. Tai, D. Nguyen, R.K. Pooh, A. Shiozaki, M. Zheng, Y. Hu, B. Li, R.A. Kusuma, P. Yapan, M. Choolani, M. Tokunaka, S. Luewan, T. Chang, N. Chaiyasit, T. Nanthakomon, H. Liu, S. Shaw, W. Leung, Z.A. Mahdy, A.S. Aguilar, H. Leung, N. Lee, S. Lau, X. Lu, D.S. Sahota, K. Chong, L.C. Poon
Institutions: Chinese University of Hong Kong, King's College London, Bệnh viện Phụ Sản Hà Nội, University of Toyama, Nanjing Drum Tower Hospital, Nanjing University, First Affiliated Hospital of Kunming Medical University, Siriraj Hospital, Mahidol University, National University Hospital, SHOWA Medical University, Chiang Mai University, King Chulalongkorn Memorial Hospital, Thammasat University, Guangzhou Women and Children Medical Center, Chang Gung Memorial Hospital, Kwong Wah Hospital, National University of Malaysia, University of the Philippines Manila, Chinese University of Hong Kong, Shenzhen
Language: English
Subfield: Obstetrics and Gynecology
Field: Medicine
Domain: Health Sciences
Open Access status: bronze
Funders: 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
OpenAlex ID: W4402360267