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Hemodynamic and developmental biomarkers enhance prenatal coarctation prediction: a validated multiparametric ultrasound model

Year: 2025

Type: article

Abstract: PURPOSE: To develop and validate a prenatal prediction model for aortic coarctation (CoA) using morphologic, hemodynamic, and fetal growth parameters to enhance diagnostic accuracy and guide clinical decision-making. METHOD: Eighty-three fetuses with suspected CoA were retrospectively analyzed. Key prenatal predictors were analyzed using multivariable logistic regression to construct a nomogram. Model performance was evaluated via area under the receiver operating characteristic curve (AUC), calibration plots, and decision curve analysis (DCA). RESULTS: Of the 83 fetuses, 28 (33.7%) were postnatally confirmed with CoA. The final model identified abdominal-to-head circumference ratio × 100% (β = 0.90, 95% CI 0.22-1.58), maximum aortic arch z-score (β = - 0.85, 95% CI - 1.50 to - 0.19), ventricular septal defect (OR = 1.85, 95% CI 1.02-3.53), and abnormal atrial hemodynamics (OR = 0.73, 95% CI 0.38-1.39) as significant predictors. The model achieved an AUC of 0.86 (95% CI 0.78-0.94), with calibration plots demonstrating strong agreement between predicted and observed probabilities. DCA confirmed clinical utility across a wide threshold range. CONCLUSIONS: This nomogram enhances CoA prediction by integrating structural and functional ultrasound markers. It offers strong diagnostic performance and practical value for prenatal risk stratification, potentially reducing false positives and unnecessary interventions.

Source: Archives of Gynecology and Obstetrics

DOI: 10.1007/s00404-025-08204-2

Authors: Yu Wang, Shuhua Luo, Weiqiang Ruan, Nan Guo

Institutions: Sichuan University, West China Second University Hospital of Sichuan University

Language: English

Topic: Congenital Heart Disease Studies

Subfield: Epidemiology

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $4,590