{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,3]],"date-time":"2026-07-03T09:58:55Z","timestamp":1783072735751,"version":"3.54.6"},"reference-count":26,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2019,6,10]],"date-time":"2019-06-10T00:00:00Z","timestamp":1560124800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100003123","name":"Fetal Medicine Foundation","doi-asserted-by":"publisher","award":["1037116"],"award-info":[{"award-number":["1037116"]}],"id":[{"id":"10.13039\/501100003123","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Ultrasound in Obstet &amp;amp; Gyne"],"published-print":{"date-parts":[[2019,7]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>To investigate the potential value of uterine artery pulsatility index (UtA\u2010PI) and serum levels of the angiogenic placental growth factor (PlGF) and the antiangiogenic factor soluble fms\u2010like tyrosine kinase\u20101 (sFlt\u20101) in the prediction of adverse perinatal outcome in small\u2010for\u2010gestational\u2010age (SGA) and non\u2010SGA neonates at 35\u201337\u2009weeks' gestation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This was a prospective observational study of 19\u2009209 singleton pregnancies attending for a routine hospital visit at 35\u2009+\u20090 to 36\u2009+\u20096\u2009weeks' gestation. This visit included recording of maternal demographic characteristics and medical history, sonographic estimation of fetal weight, color Doppler ultrasound for measurement of mean UtA\u2010PI, and measurement of serum concentrations of PlGF and sFlt\u20101. Multivariable logistic regression analysis was carried out to determine which of the factors from maternal or pregnancy characteristics and measurements of UtA\u2010PI, PlGF and sFlt\u20101 provided a significant contribution in the prediction of each of four adverse outcome measures: first, stillbirth; second, Cesarean delivery for suspected fetal compromise in labor; third, neonatal death or hypoxic ischemic encephalopathy Grade 2 or 3; and, fourth, admission to the neonatal unit (NNU) for \u2265\u200948\u2009h. Predicted probabilities from logistic regression analysis were used to construct receiver\u2013operating characteristics curves to assess the performance of screening for these adverse outcomes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>First, 83% of stillbirths, 82% of Cesarean sections for presumed fetal compromise in labor, 91% of cases of neonatal death or hypoxic ischemic encephalopathy and 86% of NNU admissions for \u2265\u200948\u2009h occurred in pregnancies with a non\u2010SGA neonate. Second, UtA\u2010PI &gt;\u200995<jats:sup>th<\/jats:sup> percentile, sFlt\u20101\u2009&gt;\u200995<jats:sup>th<\/jats:sup> percentile and PlGF &lt;\u20095<jats:sup>th<\/jats:sup> percentile were associated with increased risk of Cesarean delivery for suspected fetal compromise in labor and NNU admission for \u2265\u200948\u2009h; the number of stillbirths and cases of neonatal death or hypoxic ischemic encephalopathy was too small to demonstrate significance in the observed differences from cases without these adverse outcomes. Third, multivariable logistic regression analysis demonstrated that, in the prediction of Cesarean delivery for suspected fetal compromise in labor, there was no significant contribution from biomarkers; the prediction of NNU admission for \u2265\u200948\u2009h by maternal demographic characteristics and medical history was only marginally improved by the addition of sFlt\u20101 or PlGF. Fourth, for each biomarker, the detection rate of adverse outcome was higher in SGA than in non\u2010SGA neonates, but this increase was accompanied by an increase in false\u2010positive rate. Fifth, the relative risk of UtA\u2010PI &gt;\u200995<jats:sup>th<\/jats:sup>, sFlt\u20101\u2009&gt;\u200995<jats:sup>th<\/jats:sup> and PlGF &lt;\u20095<jats:sup>th<\/jats:sup> percentiles for most adverse outcomes was &lt;\u20092.5 in both SGA and non\u2010SGA neonates.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>In pregnancies undergoing routine antenatal assessment at 35\u201337\u2009weeks' gestation, measurements of UtA\u2010PI, sFlt\u20101 or PlGF provide poor prediction of adverse perinatal outcome in both SGA and non\u2010SGA fetuses. Copyright \u00a9 2019 ISUOG. Published by John Wiley &amp; Sons Ltd.<\/jats:p><\/jats:sec>","DOI":"10.1002\/uog.20346","type":"journal-article","created":{"date-parts":[[2019,5,17]],"date-time":"2019-05-17T16:10:54Z","timestamp":1558109454000},"page":"79-86","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":40,"title":["Biomarkers of impaired placentation at 35\u201337\u2009weeks' gestation in the prediction of adverse perinatal outcome"],"prefix":"10.1002","volume":"54","author":[{"given":"A.","family":"Ciobanou","sequence":"first","affiliation":[{"name":"Fetal Medicine Research Institute King's College Hospital  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S.","family":"Jabak","sequence":"additional","affiliation":[{"name":"Fetal Medicine Research Institute King's College Hospital  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"H.","family":"De Castro","sequence":"additional","affiliation":[{"name":"Fetal Medicine Research Institute King's College Hospital  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"L.","family":"Frei","sequence":"additional","affiliation":[{"name":"Fetal Medicine Research Institute King's College Hospital  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7265-5442","authenticated-orcid":false,"given":"R.","family":"Akolekar","sequence":"additional","affiliation":[{"name":"Fetal Medicine Unit Medway Maritime Hospital  Gillingham UK"},{"name":"Institute of Medical Sciences Canterbury Christ Church University  Chatham UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"K. H.","family":"Nicolaides","sequence":"additional","affiliation":[{"name":"Fetal Medicine Research Institute King's College Hospital  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2019,6,10]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2019.01.235"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2019.01.227"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.15812"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.19111"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.14862"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.14847"},{"key":"e_1_2_6_8_1","first-page":"630","article-title":"Two\u2010stage approach for prediction of small for gestational age neonates and adverse perinatal outcome by routine ultrasound examination at 35\u201337\u2009weeks' gestation","volume":"53","author":"Akolekar R","year":"2019","journal-title":"Ultrasound Obstet Gynecol"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2019.03.002"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.14822"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.semperi.2003.10.013"},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9378(85)90298-4"},{"key":"e_1_2_6_13_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.19066"},{"key":"e_1_2_6_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0029-7844(00)00946-7"},{"key":"e_1_2_6_15_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1471-0528.1975.tb00710.x"},{"key":"e_1_2_6_16_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1469-0705.1994.04010034.x"},{"key":"e_1_2_6_17_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.15663"},{"key":"e_1_2_6_18_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1471-0528.2007.01479.x"},{"key":"e_1_2_6_19_1","unstructured":"National Collaborating Centre for Women's and Children's Health (UK). Intrapartum Care: Care of Healthy Women and Their Babies During Childbirth. National Institute for Health and Care Excellence: Clinical Guidelines2014."},{"key":"e_1_2_6_20_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.19073"},{"key":"e_1_2_6_21_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.14789"},{"key":"e_1_2_6_22_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.14928"},{"key":"e_1_2_6_23_1","doi-asserted-by":"publisher","DOI":"10.1159\/000480381"},{"key":"e_1_2_6_24_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2352-4642(18)30129-9"},{"key":"e_1_2_6_25_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(15)00131-2"},{"key":"e_1_2_6_26_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.14898"},{"key":"e_1_2_6_27_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.15979"}],"container-title":["Ultrasound in Obstetrics &amp; Gynecology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Fuog.20346","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/uog.20346","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/uog.20346","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/uog.20346","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,10]],"date-time":"2023-09-10T01:34:41Z","timestamp":1694309681000},"score":1,"resource":{"primary":{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/10.1002\/uog.20346"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,6,10]]},"references-count":26,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2019,7]]}},"alternative-id":["10.1002\/uog.20346"],"URL":"https:\/\/doi.org\/10.1002\/uog.20346","archive":["Portico"],"relation":{},"ISSN":["0960-7692","1469-0705"],"issn-type":[{"value":"0960-7692","type":"print"},{"value":"1469-0705","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,6,10]]},"assertion":[{"value":"2019-04-17","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2019-05-13","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2019-06-10","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}