{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,3]],"date-time":"2026-07-03T08:35:04Z","timestamp":1783067704259,"version":"3.54.6"},"reference-count":31,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2018,3,7]],"date-time":"2018-03-07T00:00:00Z","timestamp":1520380800000},"content-version":"vor","delay-in-days":6,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Ultrasound in Obstet &amp; Gyne"],"published-print":{"date-parts":[[2018,3]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>To investigate the fetal cerebroplacental ratio (CPR) in women presenting with reduced fetal movements (RFM).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This was a retrospective cohort study of data collected over an 8\u2010year period at a fetal medicine unit at a tertiary referral center. The cohort comprised 4500 singleton pregnancies presenting with RFM at or after 36\u2009weeks' gestation and 1527 control pregnancies at a similar gestational age without RFM. Fetal biometry and Doppler parameters were recorded and converted into centiles and multiples of the median (MoM). CPR was defined as the ratio between the fetal middle cerebral artery (MCA) pulsatility index (PI) and the umbilical artery (UA) PI. Subgroup analysis for fetal size and for single <jats:italic>vs<\/jats:italic> multiple episodes of RFM was performed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Compared with controls, pregnancies with RFM had lower MCA\u2010PI MoM (median, 0.95 <jats:italic>vs<\/jats:italic> 0.97; <jats:italic>P<\/jats:italic>\u00a0&lt;\u20090.001) and CPR MoM (median, 0.97 <jats:italic>vs<\/jats:italic> 0.99; <jats:italic>P<\/jats:italic>\u00a0=\u20090.018). Compared with women presenting with single episodes of RFM, pregnancies with multiple episodes (\u2265 2 episodes) had lower CPR MoM (median, 0.94 <jats:italic>vs<\/jats:italic> 0.98; <jats:italic>P<\/jats:italic>\u00a0=\u20090.003). On subgroup analysis for fetal size, compared with controls, appropriate\u2010for\u2010gestational\u2010age fetuses in the RFM group had lower MCA\u2010PI MoM (median, 0.96 <jats:italic>vs<\/jats:italic> 0.97; <jats:italic>P<\/jats:italic>\u00a0=\u20090.003) and higher rate of CPR below the 5<jats:sup>th<\/jats:sup> centile (5.3% <jats:italic>vs<\/jats:italic> 3.6%; <jats:italic>P<\/jats:italic>\u00a0=\u20090.015). Logistic regression analysis demonstrated an association of risk of recurrent RFM with maternal age (OR, 0.96; 95% CI, 0.93\u20130.99), non\u2010Caucasian ethnicity (OR, 0.72; 95% CI, 0.53\u20130.97), estimated fetal weight centile (OR, 1.01; 95% CI, 1.00\u20131.02) and CPR MoM (OR, 0.24; 95% CI, 0.12\u20130.47).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Pregnancies complicated by multiple episodes of RFM show significantly lower CPR MoM and MCA\u2010PI MoM compared with those with single episodes and controls. This is likely to be due to worsening fetal hypoxemia in women presenting with recurrent RFM. Copyright \u00a9 2017 ISUOG. Published by John Wiley &amp; Sons Ltd.<\/jats:p><\/jats:sec>","DOI":"10.1002\/uog.18830","type":"journal-article","created":{"date-parts":[[2017,8,7]],"date-time":"2017-08-07T07:56:47Z","timestamp":1502092607000},"page":"375-380","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":23,"title":["Reduced fetal movements and cerebroplacental ratio: evidence for worsening fetal hypoxemia"],"prefix":"10.1002","volume":"51","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5725-9270","authenticated-orcid":false,"given":"J.","family":"Binder","sequence":"first","affiliation":[{"name":"Fetal Medicine Unit St George's University Hospitals NHS Foundation Trust  London UK"},{"name":"Department of Obstetrics and Fetomaternal Medicine Medical University of Vienna  Vienna Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8453-1375","authenticated-orcid":false,"given":"C.","family":"Monaghan","sequence":"additional","affiliation":[{"name":"Fetal Medicine Unit St George's University Hospitals NHS Foundation Trust  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"B.","family":"Thilaganathan","sequence":"additional","affiliation":[{"name":"Fetal Medicine Unit St George's University Hospitals NHS Foundation Trust  London UK"},{"name":"Molecular and Clinical Sciences Research Institute, St George's University of London  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J.","family":"Morales\u2010Rosell\u00f3","sequence":"additional","affiliation":[{"name":"Servicio de Obstetricia Hospital Universitario y Polit\u00e9cnico La Fe  Valencia Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2802-7670","authenticated-orcid":false,"given":"A.","family":"Khalil","sequence":"additional","affiliation":[{"name":"Fetal Medicine Unit St George's University Hospitals NHS Foundation Trust  London UK"},{"name":"Molecular and Clinical Sciences Research Institute, St George's University of London  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2018,3,7]]},"reference":[{"key":"e_1_2_5_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1523-536X.2011.00490.x"},{"key":"e_1_2_5_3_1","first-page":"53","article-title":"study of factors associated with intrauterine fetal deaths","volume":"6","author":"Efkarpidis S","year":"2004","journal-title":"MedGenMed"},{"key":"e_1_2_5_4_1","doi-asserted-by":"publisher","DOI":"10.1067\/mob.2001.110697"},{"key":"e_1_2_5_5_1","doi-asserted-by":"publisher","DOI":"10.1080\/01443610801912618"},{"key":"e_1_2_5_6_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.1.6021.1305"},{"key":"e_1_2_5_7_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.semperi.2008.04.015"},{"key":"e_1_2_5_8_1","unstructured":"AFFIRM. 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