{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,31]],"date-time":"2026-10-31T17:37:53Z","timestamp":1793468273615,"version":"4.5.0"},"reference-count":16,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2020,8,1]],"date-time":"2020-08-01T00:00:00Z","timestamp":1596240000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100003042","name":"Else Kr\u00f6ner-Fresenius-Stiftung","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100003042","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000761","name":"Imperial College London","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000761","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Ultrasound in Obstet &amp; Gyne"],"published-print":{"date-parts":[[2020,8]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Objectives<\/jats:title><jats:p>To explore the association between fetal umbilical and middle cerebral artery (MCA) Doppler abnormalities and outcome in late preterm pregnancies at risk of fetal growth restriction.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This was a prospective cohort study of singleton pregnancies at risk of fetal growth restriction at 32\u2009+\u20090 to 36\u2009+\u20096\u2009weeks of gestation, enrolled in 33 European centers between 2017 and 2018, in which umbilical and fetal MCA Doppler velocimetry was performed. Pregnancies were considered at risk of fetal growth restriction if they had estimated fetal weight and\/or abdominal circumference (AC) &lt;\u200910<jats:sup>th<\/jats:sup> percentile, abnormal arterial Doppler and\/or a fall in AC growth velocity of more than 40 percentile points from the 20\u2010week scan. Composite adverse outcome comprised both immediate adverse birth outcome and major neonatal morbidity. Using a range of cut\u2010off values, the association of MCA pulsatility index and umbilicocerebral ratio (UCR) with composite adverse outcome was explored.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The study population comprised 856 women. There were two (0.2%) intrauterine deaths. Median gestational age at delivery was 38 (interquartile range (IQR), 37\u201339)\u2009weeks and birth weight was 2478 (IQR, 2140\u20132790)\u2009g. Compared with infants with normal outcome, those with composite adverse outcome (<jats:italic>n<\/jats:italic>\u2009=\u200993; 11%) were delivered at an earlier gestational age (36 <jats:italic>vs<\/jats:italic> 38\u2009weeks) and had a lower birth weight (1900 <jats:italic>vs<\/jats:italic> 2540\u2009g). The first Doppler observation of MCA pulsatility index &lt;\u20095<jats:sup>th<\/jats:sup> percentile and UCR <jats:italic>Z<\/jats:italic>\u2010score above gestational\u2010age\u2010specific thresholds (1.5 at 32\u201333\u2009weeks and 1.0 at 34\u201336\u2009weeks) had the highest relative risks (RR) for composite adverse outcome (RR 2.2 (95%\u2009CI, 1.5\u20133.2) and RR 2.0 (95%\u2009CI, 1.4\u20133.0), respectively). After adjustment for confounders, the association between UCR <jats:italic>Z<\/jats:italic>\u2010score and composite adverse outcome remained significant, although gestational age at delivery and birth\u2010weight <jats:italic>Z<\/jats:italic>\u2010score had a stronger association.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>In this prospective multicenter study, signs of cerebral blood flow redistribution were found to be associated with adverse outcome in late preterm singleton pregnancies at risk of fetal growth restriction. Whether cerebral redistribution is a marker describing the severity of fetal growth restriction or an independent risk factor for adverse outcome remains unclear, and whether it is useful for clinical management can be answered only in a randomized trial. \u00a9 2020 The Authors. <jats:italic>Ultrasound in Obstetrics &amp; Gynecology<\/jats:italic> published by John Wiley &amp; Sons Ltd on behalf of the International Society of Ultrasound in Obstetrics and Gynecology.<\/jats:p><\/jats:sec>","DOI":"10.1002\/uog.22125","type":"journal-article","created":{"date-parts":[[2020,6,18]],"date-time":"2020-06-18T05:45:07Z","timestamp":1592459107000},"page":"173-181","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":87,"title":["Fetal cerebral Doppler changes and outcome in late preterm fetal growth restriction: prospective cohort study"],"prefix":"10.1002","volume":"56","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9080-3848","authenticated-orcid":false,"given":"T.","family":"Stampalija","sequence":"first","affiliation":[{"name":"Unit of Fetal Medicine and Prenatal Diagnosis Institute for Maternal and Child Health, IRCCS Burlo Garofolo  Trieste Italy"},{"name":"Department of Medicine, Surgery and Health Sciences University of Trieste  Trieste Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J.","family":"Thornton","sequence":"additional","affiliation":[{"name":"School of Clinical Sciences, University of Nottingham, Division of Obstetrics and Gynaecology, Maternity Department City Hospital  Nottingham UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"N.","family":"Marlow","sequence":"additional","affiliation":[{"name":"UCL Elizabeth Garrett Anderson Institute for Women's Health University College London  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R.","family":"Napolitano","sequence":"additional","affiliation":[{"name":"UCL Elizabeth Garrett Anderson Institute for Women's Health University College London  London UK"},{"name":"Fetal Medicine Unit University College London Hospitals NHS Foundation Trust  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2393-7501","authenticated-orcid":false,"given":"A.","family":"Bhide","sequence":"additional","affiliation":[{"name":"Fetal Medicine Unit St George's University Hospitals NHS Foundation Trust and Molecular &amp; Clinical Sciences Research Institute, St George's, University of London  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7743-0234","authenticated-orcid":false,"given":"T.","family":"Pickles","sequence":"additional","affiliation":[{"name":"Centre for Trials Research, College of Biomedical and Life Sciences Cardiff University  Cardiff UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1894-0626","authenticated-orcid":false,"given":"C. M.","family":"Bilardo","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Amsterdam University Medical Centers, University of Amsterdam, Amsterdam Reproduction and Development Research Institute  Amsterdam The Netherlands"},{"name":"Department of Obstetrics and Gynaecology University Medical Center Groningen, University of Groningen  Groningen The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S. J.","family":"Gordijn","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology University Medical Center Groningen, University of Groningen  Groningen The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5778-434X","authenticated-orcid":false,"given":"W.","family":"Gyselaers","sequence":"additional","affiliation":[{"name":"Faculty of Medicine and Life Sciences Hasselt University, Agoralaan  Diepenbeek Belgium"},{"name":"Department of Obstetrics &amp; Gynaecology, Ziekenhuis Oost\u2010Limburg, Genk and Department Physiology Hasselt University  Diepenbeek Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4764-544X","authenticated-orcid":false,"given":"H.","family":"Valensise","sequence":"additional","affiliation":[{"name":"Department of Surgery, Division of Obstetrics and Gynecology Tor Vergata University, Policlinico Casilino Hospital  Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3172-1164","authenticated-orcid":false,"given":"K.","family":"Hecher","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Fetal Medicine University Medical Centre Hamburg\u2010Eppendorf  Hamburg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R. K.","family":"Sande","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Stavanger University Hospital, Stavanger and Department of Clinical Science, University of Bergen  Bergen Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"P.","family":"Lindgren","sequence":"additional","affiliation":[{"name":"Center for Fetal Medicine Karolinska University Hospital  Stockholm Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"E.","family":"Bergman","sequence":"additional","affiliation":[{"name":"Department of Women's and Children's Health Uppsala University  Uppsala Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"B.","family":"Arabin","sequence":"additional","affiliation":[{"name":"Department of Obstetrics Charite Humboldt University Berlin and Clara Angela Foundation  Berlin Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4836-1860","authenticated-orcid":false,"given":"A. 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