{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T19:06:11Z","timestamp":1792782371435,"version":"4.5.0"},"reference-count":74,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2018,9,5]],"date-time":"2018-09-05T00:00:00Z","timestamp":1536105600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100000272","name":"National Institute for Health Research (NIHR)","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100000272","id-type":"DOI","asserted-by":"crossref"}]},{"name":"Biomedical Research Centre (BRC)"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Ultrasound in Obstet &amp;amp; Gyne"],"published-print":{"date-parts":[[2018,10]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>The cerebroplacental ratio (CPR) has been proposed for the routine surveillance of pregnancies with suspected fetal growth restriction (FGR), but the predictive performance of this test is unclear. The aim of this study was to determine the accuracy of CPR for predicting adverse perinatal and neurodevelopmental outcomes in suspected FGR.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>PubMed, EMBASE, CINAHL and Lilacs were searched from inception to 31 July 2017 for cohort or cross\u2010sectional studies reporting on the accuracy of CPR for predicting adverse perinatal and\/or neurodevelopmental outcomes in singleton pregnancies with FGR suspected antenatally based on sonographic parameters. Summary receiver\u2013operating characteristics (ROC) curves, pooled sensitivities and specificities, and summary likelihood ratios (LRs) were generated.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Twenty\u2010two studies (including 4301 women) met the inclusion criteria. Summary ROC curves showed that the best predictive accuracy of CPR was for perinatal death and the worst was for neonatal acidosis, with areas under the summary ROC curves of 0.83 and 0.57, respectively. The predictive accuracy of CPR was moderate to high for perinatal death (pooled sensitivity and specificity of 93% and 76%, respectively, and summary positive and negative LRs of 3.9 and 0.09, respectively) and low for composite of adverse perinatal outcomes, Cesarean section for non\u2010reassuring fetal status, 5\u2010min Apgar score\u2009&lt;\u20097, admission to the neonatal intensive care unit, neonatal acidosis and neonatal morbidity, with summary positive and negative LRs ranging from 1.1 to 2.5 and 0.3 to 0.9, respectively. An abnormal CPR result had moderate accuracy for predicting small\u2010for\u2010gestational age at birth (summary positive LR of 7.4). CPR had a higher predictive accuracy in pregnancies with suspected early\u2010onset FGR. No study provided data for assessing the predictive accuracy of CPR for adverse neurodevelopmental outcome.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>CPR appears to be useful in predicting perinatal death in pregnancies with suspected FGR. Nevertheless, before incorporating CPR into the routine clinical management of suspected FGR, randomized controlled trials should assess whether the use of CPR reduces perinatal death or other adverse perinatal outcomes. Copyright \u00a9 2018 ISUOG. Published by John Wiley &amp; Sons Ltd.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/uog.19117","type":"journal-article","created":{"date-parts":[[2018,6,19]],"date-time":"2018-06-19T14:50:25Z","timestamp":1529419825000},"page":"430-441","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":165,"title":["Predictive accuracy of cerebroplacental ratio for adverse perinatal and neurodevelopmental outcomes in suspected fetal growth restriction: systematic review and meta\u2010analysis"],"prefix":"10.1002","volume":"52","author":[{"given":"A.","family":"Conde\u2010Agudelo","sequence":"first","affiliation":[{"name":"Perinatology Research Branch, Eunice Kennedy Shriver National Institute of Child Health and Human Development\/National Institutes of Health\/Department of Health and Human Services  Bethesda MD, and Detroit, MI USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J.","family":"Villar","sequence":"additional","affiliation":[{"name":"Nuffield Department of Obstetrics &amp; Gynaecology University of Oxford, Women's Centre, John Radcliffe Hospital  Oxford UK"},{"name":"Oxford Maternal &amp; Perinatal Health Institute Green Templeton College  Oxford UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S. H.","family":"Kennedy","sequence":"additional","affiliation":[{"name":"Nuffield Department of Obstetrics &amp; Gynaecology University of Oxford, Women's Centre, John Radcliffe Hospital  Oxford UK"},{"name":"Oxford Maternal &amp; Perinatal Health Institute Green Templeton College  Oxford UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8143-2232","authenticated-orcid":false,"given":"A. 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