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We handled missing data using multiple imputation and analysed the data using descriptive methods and a binary logistic regression model.<\/jats:p><\/jats:sec><jats:sec><jats:title>Main outcome measures<\/jats:title><jats:p>Composite adverse perinatal outcome (CAPO), perinatal death and stillbirth.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>We included 995 women. The mean gestational age at Doppler scan was 36.9\u00a0weeks (SD 1.02\u00a0weeks) and 88.9% of the women gave birth in a health facility. About 4.4% and 5.6% of the UA pulsatility index (PI) and UtA\u00a0PI were above the 95th percentile, whereas 16.4% and 10.4% of the MCA\u00a0PI and CPR were below the fifth percentile, respectively. Low CPR was strongly associated with stillbirth (OR\u00a04.82, 95%\u00a0CI 1.09\u201321.30). CPR and MCA\u00a0PI below the fifth percentile were independently associated with CAPO; the association with MCA\u00a0PI was stronger in small\u2010for\u2010gestational\u2010age neonates (OR\u00a03.75, 95%\u00a0CI 1.18\u201311.88).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>In late gestation, abnormal UA\u00a0PI was rare. Fetuses with cerebral blood flow redistribution were at increased risk of stillbirth and perinatal complications. Further studies examining the predictive accuracy and effectiveness of antenatal Doppler ultrasound screening in reducing the risk of perinatal deaths in low\u2010 and middle\u2010income countries are warranted.<\/jats:p><\/jats:sec><jats:sec><jats:title>Tweetable abstract<\/jats:title><jats:p>Blood flow redistribution to the fetal brain is strongly associated with stillbirths in low\u2010resource settings.<\/jats:p><\/jats:sec>","DOI":"10.1111\/1471-0528.17115","type":"journal-article","created":{"date-parts":[[2022,2,4]],"date-time":"2022-02-04T08:54:48Z","timestamp":1643964888000},"page":"1712-1720","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Middle cerebral arterial flow redistribution is an indicator for intrauterine fetal compromise in late pregnancy in low\u2010resource settings: A prospective cohort study"],"prefix":"10.1111","volume":"129","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5459-2804","authenticated-orcid":false,"given":"Sam","family":"Ali","sequence":"first","affiliation":[{"name":"Julius Global Health, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht Utrecht University  Utrecht The Netherlands"},{"name":"School of Medicine Makerere University College of Health Sciences  Kampala Uganda"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael G.","family":"Kawooya","sequence":"additional","affiliation":[{"name":"Ernest Cook Ultrasound Research and Education Institute (ECUREI), Mengo Hospital  Kampala Uganda"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Josaphat","family":"Byamugisha","sequence":"additional","affiliation":[{"name":"School of Medicine Makerere University College of Health Sciences  Kampala Uganda"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Isaac 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