{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T14:39:23Z","timestamp":1787063963953,"version":"build-2736575974"},"reference-count":19,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2018,2,7]],"date-time":"2018-02-07T00:00:00Z","timestamp":1517961600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Ultrasound in Obstet & Gyne"],"published-print":{"date-parts":[[2018,3]]},"abstract":"Abstract<\/jats:title>\n \n Objectives<\/jats:title>\n To evaluate the relationship between cerebroplacental ratio (CPR) and estimated fetal weight (EFW) in low\u2010 and high\u2010risk singleton pregnancies. Furthermore, we evaluated the role of CPR in the prediction of adverse perinatal outcome and whether CPR measurements adjusted for EFW improve its predictive value.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n \n This was a retrospective cohort study including pregnancies in which Doppler investigations of umbilical artery (UA) and fetal middle cerebral artery (MCA) were performed at \u2265\u200930 weeks' gestation. Pregnancies were allocated to one of three groups according to EFW centile: small\u2010for\u2010gestational age (SGA) with EFW <\u200910\n th<\/jats:sup>\n centile, appropriate\u2010for\u2010gestational age (AGA) and large\u2010for\u2010gestational age (LGA) with EFW > 90\n th<\/jats:sup>\n centile. CPR was calculated as the ratio between the UA pulsatility index (PI) and MCA\u2010PI and converted to CPR multiples of the median (MoMs) according to the three EFW groups. Linear regression analysis was performed to evaluate the relationship between CPR\u2010MoMs and EFW centiles in low\u2010risk pregnancies. Furthermore, MoMs of CPR adjusted according to EFW centile (aCPR\u2010MoMs) were calculated. Adverse perinatal outcome was defined as presence of pathological cardiotocography (CTG) trace, arterial cord blood pH <\u20097.1, 5\u2010min Apgar score <\u20097 and presence of meconium\u2010stained amniotic fluid (MSAF).\n <\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n A total of 3515 (3016 low risk and 499 high risk) pregnancies, delivered between January 2010 and March 2016, were included. Linear regression analysis revealed a significant positive correlation between EFW centile and CPR\u2010MoM. Receiver\u2013operating characteristics (ROC) curve analysis showed a significant association between CPR\u2010MoM and pathological CTG trace (AUC, 0.539; SD, 0.014;\n P<\/jats:italic>\n \u2009=\u20090.005) and low Apgar score (AUC, 0.609; SD, 0.041;\n P<\/jats:italic>\n \u2009=\u20090.008), but not with low arterial pH or MSAF. There was a significant association between aCPR\u2010MoM and pathological CTG trace (AUC, 0.540; SD, 0.014;\n P<\/jats:italic>\n \u2009=\u20090.003), low arterial cord blood pH (AUC, 0.546; SD, 0.022;\n P<\/jats:italic>\n \u2009=\u20090.035) and low Apgar score (AUC, 0.609; SD, 0.044;\n P<\/jats:italic>\n \u2009=\u20090.008), but not with MSAF. However, detection rates for adverse perinatal outcomes by CPR\u2010MoM and aCPR\u2010MoM were low, ranging from 6.7% to 28.6% for SGA, 12.1% to 22.2% for AGA and 0% to 33.3% for LGA, for a false\u2010positive rate of 10%. In a subgroup analysis of cases in which ultrasound examination was performed at \u2265\u200934 weeks of gestation and within 4 weeks of delivery (\n n<\/jats:italic>\n \u2009=\u20091439), the ROC curves for aCPR\u2010MoM were significantly associated with all four outcomes evaluated.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n CPR\u2010MoM values are dependent on EFW centiles; therefore, we suggest that CPR\u2010MoM should be adjusted for EFW centile. However, both CPR\u2010 and aCPR\u2010MoM showed a low prediction rate for adverse perinatal outcome. Copyright \u00a9 2017 ISUOG. Published by John Wiley & Sons Ltd.<\/jats:p>\n <\/jats:sec>","DOI":"10.1002\/uog.17458","type":"journal-article","created":{"date-parts":[[2017,3,14]],"date-time":"2017-03-14T11:14:46Z","timestamp":1489490086000},"page":"381-386","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":27,"title":["Prediction of adverse perinatal outcome by cerebroplacental ratio adjusted for estimated fetal weight"],"prefix":"10.1002","volume":"51","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0593-9063","authenticated-orcid":false,"given":"A.","family":"Sirico","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Fetal Medicine University Medical Center Hamburg\u2010Eppendorf Hamburg Germany"},{"name":"High Risk Pregnancy Centre\u2013Department of Neurosciences, Reproductive and Dentistry Sciences University Federico II Naples 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