Human fetal cardiovascular profile score and neonatal outcome in intrauterine growth restriction

K. Mäkikallio, Juha Rasanen, T. Mäkikallio, O. Vuolteenaho, J. C. Huhta

Research output: Contribution to journalArticle

57 Citations (Scopus)

Abstract

Objective: To determine whether low cardiovascular profile (CVP) score has prognostic value for predicting neonatal mortality and severe morbidity in human fetuses with growth restriction. Methods: Seventy-five consecutive growth-restricted fetuses with Doppler examination of cardiovascular hemodynamics within a week prior to delivery comprised the study population. Hydrops, heart size, cardiac function and venous and arterial hemodynamics were evaluated for CVP score. The primary outcome measures were neonatal mortality and cerebral palsy. Results: During the neonatal period, six of 75 neonates died and two had cerebral palsy (Group 1, n = 8). Compared with the fetuses discharged home from hospital (Group 2, n = 67), those in Group 1 were delivered at an earlier gestational age (28 (range, 24-35) weeks vs. 35 (range, 26-40) weeks, P <0.01) and had lower CVP scores (4 (range, 2-6) vs. 9 (range, 5-10), P <0.0001). All CVP subscale scores were lower (P <0.01) in Group 1 than in Group 2 fetuses. Gestational age-adjusted hazard ratios (95% CIs) for adverse neonatal outcome were highest for cardiomegaly (13.9 (1.7-114.3), P = 0.014), monophasic atrioventricular filling pattern or holosystolic tricuspid regurgitation (9.5 (2.3-38.4), P = 0.002) and atrial pulsations in the umbilical vein 7.7 (1.4-41.2), P = 0.017). Conclusions: Growth-restricted fetuses with adverse neonatal outcome have lower CVP scores than do fetuses with favorable neonatal outcome. The strongest predictors for adverse neonatal outcome in the CVP score were cardiomegaly, abnormal cardiac function with monophasic atrioventricular filling or holosystolic tricuspid regurgitation and increased systemic venous pressure. These assessments have independent prognostic power for adverse neonatal outcome even after adjustment for gestational age.

Original languageEnglish (US)
Pages (from-to)48-54
Number of pages7
JournalUltrasound in Obstetrics and Gynecology
Volume31
Issue number1
DOIs
StatePublished - Jan 2008

Fingerprint

fetuses
constrictions
Fetus
Growth
profiles
Gestational Age
Tricuspid Valve Insufficiency
hemodynamics
mortality
Cardiomegaly
Infant Mortality
Cerebral Palsy
Hemodynamics
Group Homes
Umbilical Veins
Venous Pressure
veins
hazards
Edema
delivery

Keywords

  • Atrial natriuretic peptide
  • Doppler
  • Fetal heart failure
  • Neonatal morbidity
  • Neonatal mortality

ASJC Scopus subject areas

  • Obstetrics and Gynecology
  • Radiology Nuclear Medicine and imaging
  • Radiological and Ultrasound Technology
  • Reproductive Medicine
  • Acoustics and Ultrasonics

Cite this

Human fetal cardiovascular profile score and neonatal outcome in intrauterine growth restriction. / Mäkikallio, K.; Rasanen, Juha; Mäkikallio, T.; Vuolteenaho, O.; Huhta, J. C.

In: Ultrasound in Obstetrics and Gynecology, Vol. 31, No. 1, 01.2008, p. 48-54.

Research output: Contribution to journalArticle

Mäkikallio, K. ; Rasanen, Juha ; Mäkikallio, T. ; Vuolteenaho, O. ; Huhta, J. C. / Human fetal cardiovascular profile score and neonatal outcome in intrauterine growth restriction. In: Ultrasound in Obstetrics and Gynecology. 2008 ; Vol. 31, No. 1. pp. 48-54.
@article{6471218e500e4c649257d0390209372b,
title = "Human fetal cardiovascular profile score and neonatal outcome in intrauterine growth restriction",
abstract = "Objective: To determine whether low cardiovascular profile (CVP) score has prognostic value for predicting neonatal mortality and severe morbidity in human fetuses with growth restriction. Methods: Seventy-five consecutive growth-restricted fetuses with Doppler examination of cardiovascular hemodynamics within a week prior to delivery comprised the study population. Hydrops, heart size, cardiac function and venous and arterial hemodynamics were evaluated for CVP score. The primary outcome measures were neonatal mortality and cerebral palsy. Results: During the neonatal period, six of 75 neonates died and two had cerebral palsy (Group 1, n = 8). Compared with the fetuses discharged home from hospital (Group 2, n = 67), those in Group 1 were delivered at an earlier gestational age (28 (range, 24-35) weeks vs. 35 (range, 26-40) weeks, P <0.01) and had lower CVP scores (4 (range, 2-6) vs. 9 (range, 5-10), P <0.0001). All CVP subscale scores were lower (P <0.01) in Group 1 than in Group 2 fetuses. Gestational age-adjusted hazard ratios (95{\%} CIs) for adverse neonatal outcome were highest for cardiomegaly (13.9 (1.7-114.3), P = 0.014), monophasic atrioventricular filling pattern or holosystolic tricuspid regurgitation (9.5 (2.3-38.4), P = 0.002) and atrial pulsations in the umbilical vein 7.7 (1.4-41.2), P = 0.017). Conclusions: Growth-restricted fetuses with adverse neonatal outcome have lower CVP scores than do fetuses with favorable neonatal outcome. The strongest predictors for adverse neonatal outcome in the CVP score were cardiomegaly, abnormal cardiac function with monophasic atrioventricular filling or holosystolic tricuspid regurgitation and increased systemic venous pressure. These assessments have independent prognostic power for adverse neonatal outcome even after adjustment for gestational age.",
keywords = "Atrial natriuretic peptide, Doppler, Fetal heart failure, Neonatal morbidity, Neonatal mortality",
author = "K. M{\"a}kikallio and Juha Rasanen and T. M{\"a}kikallio and O. Vuolteenaho and Huhta, {J. C.}",
year = "2008",
month = "1",
doi = "10.1002/uog.5210",
language = "English (US)",
volume = "31",
pages = "48--54",
journal = "Ultrasound in Obstetrics and Gynecology",
issn = "0960-7692",
publisher = "John Wiley and Sons Ltd",
number = "1",

}

TY - JOUR

T1 - Human fetal cardiovascular profile score and neonatal outcome in intrauterine growth restriction

AU - Mäkikallio, K.

AU - Rasanen, Juha

AU - Mäkikallio, T.

AU - Vuolteenaho, O.

AU - Huhta, J. C.

PY - 2008/1

Y1 - 2008/1

N2 - Objective: To determine whether low cardiovascular profile (CVP) score has prognostic value for predicting neonatal mortality and severe morbidity in human fetuses with growth restriction. Methods: Seventy-five consecutive growth-restricted fetuses with Doppler examination of cardiovascular hemodynamics within a week prior to delivery comprised the study population. Hydrops, heart size, cardiac function and venous and arterial hemodynamics were evaluated for CVP score. The primary outcome measures were neonatal mortality and cerebral palsy. Results: During the neonatal period, six of 75 neonates died and two had cerebral palsy (Group 1, n = 8). Compared with the fetuses discharged home from hospital (Group 2, n = 67), those in Group 1 were delivered at an earlier gestational age (28 (range, 24-35) weeks vs. 35 (range, 26-40) weeks, P <0.01) and had lower CVP scores (4 (range, 2-6) vs. 9 (range, 5-10), P <0.0001). All CVP subscale scores were lower (P <0.01) in Group 1 than in Group 2 fetuses. Gestational age-adjusted hazard ratios (95% CIs) for adverse neonatal outcome were highest for cardiomegaly (13.9 (1.7-114.3), P = 0.014), monophasic atrioventricular filling pattern or holosystolic tricuspid regurgitation (9.5 (2.3-38.4), P = 0.002) and atrial pulsations in the umbilical vein 7.7 (1.4-41.2), P = 0.017). Conclusions: Growth-restricted fetuses with adverse neonatal outcome have lower CVP scores than do fetuses with favorable neonatal outcome. The strongest predictors for adverse neonatal outcome in the CVP score were cardiomegaly, abnormal cardiac function with monophasic atrioventricular filling or holosystolic tricuspid regurgitation and increased systemic venous pressure. These assessments have independent prognostic power for adverse neonatal outcome even after adjustment for gestational age.

AB - Objective: To determine whether low cardiovascular profile (CVP) score has prognostic value for predicting neonatal mortality and severe morbidity in human fetuses with growth restriction. Methods: Seventy-five consecutive growth-restricted fetuses with Doppler examination of cardiovascular hemodynamics within a week prior to delivery comprised the study population. Hydrops, heart size, cardiac function and venous and arterial hemodynamics were evaluated for CVP score. The primary outcome measures were neonatal mortality and cerebral palsy. Results: During the neonatal period, six of 75 neonates died and two had cerebral palsy (Group 1, n = 8). Compared with the fetuses discharged home from hospital (Group 2, n = 67), those in Group 1 were delivered at an earlier gestational age (28 (range, 24-35) weeks vs. 35 (range, 26-40) weeks, P <0.01) and had lower CVP scores (4 (range, 2-6) vs. 9 (range, 5-10), P <0.0001). All CVP subscale scores were lower (P <0.01) in Group 1 than in Group 2 fetuses. Gestational age-adjusted hazard ratios (95% CIs) for adverse neonatal outcome were highest for cardiomegaly (13.9 (1.7-114.3), P = 0.014), monophasic atrioventricular filling pattern or holosystolic tricuspid regurgitation (9.5 (2.3-38.4), P = 0.002) and atrial pulsations in the umbilical vein 7.7 (1.4-41.2), P = 0.017). Conclusions: Growth-restricted fetuses with adverse neonatal outcome have lower CVP scores than do fetuses with favorable neonatal outcome. The strongest predictors for adverse neonatal outcome in the CVP score were cardiomegaly, abnormal cardiac function with monophasic atrioventricular filling or holosystolic tricuspid regurgitation and increased systemic venous pressure. These assessments have independent prognostic power for adverse neonatal outcome even after adjustment for gestational age.

KW - Atrial natriuretic peptide

KW - Doppler

KW - Fetal heart failure

KW - Neonatal morbidity

KW - Neonatal mortality

UR - http://www.scopus.com/inward/record.url?scp=38949172343&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=38949172343&partnerID=8YFLogxK

U2 - 10.1002/uog.5210

DO - 10.1002/uog.5210

M3 - Article

C2 - 18069700

AN - SCOPUS:38949172343

VL - 31

SP - 48

EP - 54

JO - Ultrasound in Obstetrics and Gynecology

JF - Ultrasound in Obstetrics and Gynecology

SN - 0960-7692

IS - 1

ER -