Role of Cerebroplacental Ratio in Predicting the Outcome of Pregnancies Complicated by Diabetes
Introduction: Our objective was to evaluate the strength of association and diagnostic performance of cerebroplacental ratio (CPR) in predicting the outcome of pregnancies complicated by pre- and gestational diabetes mellitus. Methods: PubMed, Embase, Cochrane, and Google Scholar databases were sear...
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| creator | Cardinali, Federica Panunzi, Chiara D'Antonio, Francesco Khalil, Asma Spinillo, Arsenio Arossa, Alessia Familiari, Alessandra Pagani, Giorgio Resta, Serena Rizzo, Giuseppe |
| description | Introduction: Our objective was to evaluate the strength of association and diagnostic performance of cerebroplacental ratio (CPR) in predicting the outcome of pregnancies complicated by pre- and gestational diabetes mellitus. Methods: PubMed, Embase, Cochrane, and Google Scholar databases were searched. Inclusion criteria were pregnancies complicated by gestational or pregestational diabetes undergoing ultrasound assessment of CPR. The primary outcome was a composite score of perinatal mortality and morbidity as defined by the original publication. The secondary outcomes included preterm birth gestational age (GA) at birth, mode of delivery, fetal growth restriction (FGR) or small for GA (SGA) newborn, neonatal birthweight, perinatal death (PND), Apgar score |
| doi_str_mv | 10.1159/000534483 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_karge</sourceid><recordid>TN_cdi_karger_primary_534483</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2886598052</sourcerecordid><originalsourceid>FETCH-LOGICAL-c294t-849d5366d3b27dd3a52315d3684dca731fd57e0c5372f75fa0593521e100785a3</originalsourceid><addsrcrecordid>eNpt0DFPwzAQBWALgSgUBnaELLHAELDjOHZGVCggIRVVZY4c-1IMSRxsd-i_J9DSielOuu_e8BA6o-SGUl7cEkI4yzLJ9tARzVKaFEWe7Q87oTxhkokROg7hY2BSsPwQjZgo0pwIcoTKuWsAuxpPwEPlXd8oDV1UDZ6raB22HX71YKyOtlvi-A54toratb8_w2XZqU5bCHji2r6xWkUwuFrje6sqiBBO0EGtmgCn2zlGb9OHxeQpeZk9Pk_uXhKdFllMZFYYzvLcsCoVxjDFU0a5YbnMjFaC0dpwAURzJtJa8FoRXjCeUqCECMkVG6OrTW7v3dcKQixbGzQ0jerArUKZSpnzQpIhd4yuN1R7F4KHuuy9bZVfl5SUP32Wuz4He7GNXVUtmJ38K3AA5xvwqfwS_A7s_i__PU_vFxtR9qZm3yZ8g40</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2886598052</pqid></control><display><type>article</type><title>Role of Cerebroplacental Ratio in Predicting the Outcome of Pregnancies Complicated by Diabetes</title><source>Karger Journal Archive Collection</source><source>MEDLINE</source><creator>Cardinali, Federica ; Panunzi, Chiara ; D'Antonio, Francesco ; Khalil, Asma ; Spinillo, Arsenio ; Arossa, Alessia ; Familiari, Alessandra ; Pagani, Giorgio ; Resta, Serena ; Rizzo, Giuseppe</creator><creatorcontrib>Cardinali, Federica ; Panunzi, Chiara ; D'Antonio, Francesco ; Khalil, Asma ; Spinillo, Arsenio ; Arossa, Alessia ; Familiari, Alessandra ; Pagani, Giorgio ; Resta, Serena ; Rizzo, Giuseppe</creatorcontrib><description><![CDATA[Introduction: Our objective was to evaluate the strength of association and diagnostic performance of cerebroplacental ratio (CPR) in predicting the outcome of pregnancies complicated by pre- and gestational diabetes mellitus. Methods: PubMed, Embase, Cochrane, and Google Scholar databases were searched. Inclusion criteria were pregnancies complicated by gestational or pregestational diabetes undergoing ultrasound assessment of CPR. The primary outcome was a composite score of perinatal mortality and morbidity as defined by the original publication. The secondary outcomes included preterm birth gestational age (GA) at birth, mode of delivery, fetal growth restriction (FGR) or small for GA (SGA) newborn, neonatal birthweight, perinatal death (PND), Apgar score <7 at 5 min, abnormal acid-base status, neonatal hypoglycemia, admission to neonatal intensive care unit (NICU). Furthermore, we aimed to perform a number of sub-group analyses according to the type of diabetes (gestational and pregestational), management adopted (diet insulin or oral hypoglycemic agents), metabolic control (controlled vs. non-controlled diabetes), and fetal weight (FGR, normally grown, and large for GA fetuses). Head-to-head meta-analyses were used to directly compare the risk of each of the explored outcomes. For those outcomes found to be significant, computation of diagnostic performance of CPR was assessed using bivariate model. Results: Six studies (2,743 pregnancies) were included. The association between low CPR and adverse composite perinatal outcome was not statistically significant (p = 0.096). This result did not change when stratifying the analysis using CPR cut-off below 10th (p = 0.079) and 5th (p = 0.545) centiles. In pregnancies complicated by GDM, fetuses with a low CPR had a significantly higher risk of birthweight <10th percentile (OR: 5.83, 95% confidence interval [CI] 1.98–17.12) and this association remains significant when using a CPR <10th centile (p < 0.001). Fetuses with low CPR had also a significantly higher risk of PND (OR: 6.15, 95% CI 1.01–37.23, p < 0.001) and admission to NICU (OR 3.32, 95% CI 2.21–4.49, p < 0.001), but not of respiratory distress syndrome (p = 0.752), Apgar score <7 at 5 min (p = 0.920), abnormal acid-base status (p = 0.522), or neonatal hypoglycemia (p = 0.005). These results were confirmed when stratifying the analysis including only studies with CPR <10th centile as a cut-off to define abnormal CPR. However, CPR showed a low diagnostic accuracy for detecting perinatal outcomes. Conclusion: CPR is associated but not predictive of adverse perinatal outcome in pregnancies complicated by gestational diabetes. The findings from this systematic review do not support the use of CPR as a universal screening for pregnancy complication in women with diabetes.]]></description><identifier>ISSN: 1015-3837</identifier><identifier>ISSN: 1421-9964</identifier><identifier>EISSN: 1421-9964</identifier><identifier>DOI: 10.1159/000534483</identifier><identifier>PMID: 37926070</identifier><language>eng</language><publisher>Basel, Switzerland</publisher><subject>Birth Weight ; Diabetes, Gestational - diagnostic imaging ; Female ; Fetal Growth Retardation - diagnostic imaging ; Gestational Age ; Humans ; Hypoglycemia ; Infant, Newborn ; Infant, Small for Gestational Age ; Middle Cerebral Artery - diagnostic imaging ; Perinatal Death ; Pregnancy ; Pregnancy Outcome ; Premature Birth ; Prenatal Diagnosis ; Pulsatile Flow ; Ultrasonography, Prenatal ; Umbilical Arteries - diagnostic imaging</subject><ispartof>Fetal diagnosis and therapy, 2024-02, Vol.51 (1), p.55-65</ispartof><rights>2023 S. Karger AG, Basel</rights><rights>2023 S. Karger AG, Basel.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,27901,27902</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/37926070$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Cardinali, Federica</creatorcontrib><creatorcontrib>Panunzi, Chiara</creatorcontrib><creatorcontrib>D'Antonio, Francesco</creatorcontrib><creatorcontrib>Khalil, Asma</creatorcontrib><creatorcontrib>Spinillo, Arsenio</creatorcontrib><creatorcontrib>Arossa, Alessia</creatorcontrib><creatorcontrib>Familiari, Alessandra</creatorcontrib><creatorcontrib>Pagani, Giorgio</creatorcontrib><creatorcontrib>Resta, Serena</creatorcontrib><creatorcontrib>Rizzo, Giuseppe</creatorcontrib><title>Role of Cerebroplacental Ratio in Predicting the Outcome of Pregnancies Complicated by Diabetes</title><title>Fetal diagnosis and therapy</title><addtitle>Fetal Diagn Ther</addtitle><description><![CDATA[Introduction: Our objective was to evaluate the strength of association and diagnostic performance of cerebroplacental ratio (CPR) in predicting the outcome of pregnancies complicated by pre- and gestational diabetes mellitus. Methods: PubMed, Embase, Cochrane, and Google Scholar databases were searched. Inclusion criteria were pregnancies complicated by gestational or pregestational diabetes undergoing ultrasound assessment of CPR. The primary outcome was a composite score of perinatal mortality and morbidity as defined by the original publication. The secondary outcomes included preterm birth gestational age (GA) at birth, mode of delivery, fetal growth restriction (FGR) or small for GA (SGA) newborn, neonatal birthweight, perinatal death (PND), Apgar score <7 at 5 min, abnormal acid-base status, neonatal hypoglycemia, admission to neonatal intensive care unit (NICU). Furthermore, we aimed to perform a number of sub-group analyses according to the type of diabetes (gestational and pregestational), management adopted (diet insulin or oral hypoglycemic agents), metabolic control (controlled vs. non-controlled diabetes), and fetal weight (FGR, normally grown, and large for GA fetuses). Head-to-head meta-analyses were used to directly compare the risk of each of the explored outcomes. For those outcomes found to be significant, computation of diagnostic performance of CPR was assessed using bivariate model. Results: Six studies (2,743 pregnancies) were included. The association between low CPR and adverse composite perinatal outcome was not statistically significant (p = 0.096). This result did not change when stratifying the analysis using CPR cut-off below 10th (p = 0.079) and 5th (p = 0.545) centiles. In pregnancies complicated by GDM, fetuses with a low CPR had a significantly higher risk of birthweight <10th percentile (OR: 5.83, 95% confidence interval [CI] 1.98–17.12) and this association remains significant when using a CPR <10th centile (p < 0.001). Fetuses with low CPR had also a significantly higher risk of PND (OR: 6.15, 95% CI 1.01–37.23, p < 0.001) and admission to NICU (OR 3.32, 95% CI 2.21–4.49, p < 0.001), but not of respiratory distress syndrome (p = 0.752), Apgar score <7 at 5 min (p = 0.920), abnormal acid-base status (p = 0.522), or neonatal hypoglycemia (p = 0.005). These results were confirmed when stratifying the analysis including only studies with CPR <10th centile as a cut-off to define abnormal CPR. However, CPR showed a low diagnostic accuracy for detecting perinatal outcomes. Conclusion: CPR is associated but not predictive of adverse perinatal outcome in pregnancies complicated by gestational diabetes. The findings from this systematic review do not support the use of CPR as a universal screening for pregnancy complication in women with diabetes.]]></description><subject>Birth Weight</subject><subject>Diabetes, Gestational - diagnostic imaging</subject><subject>Female</subject><subject>Fetal Growth Retardation - diagnostic imaging</subject><subject>Gestational Age</subject><subject>Humans</subject><subject>Hypoglycemia</subject><subject>Infant, Newborn</subject><subject>Infant, Small for Gestational Age</subject><subject>Middle Cerebral Artery - diagnostic imaging</subject><subject>Perinatal Death</subject><subject>Pregnancy</subject><subject>Pregnancy Outcome</subject><subject>Premature Birth</subject><subject>Prenatal Diagnosis</subject><subject>Pulsatile Flow</subject><subject>Ultrasonography, Prenatal</subject><subject>Umbilical Arteries - diagnostic imaging</subject><issn>1015-3837</issn><issn>1421-9964</issn><issn>1421-9964</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2024</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpt0DFPwzAQBWALgSgUBnaELLHAELDjOHZGVCggIRVVZY4c-1IMSRxsd-i_J9DSielOuu_e8BA6o-SGUl7cEkI4yzLJ9tARzVKaFEWe7Q87oTxhkokROg7hY2BSsPwQjZgo0pwIcoTKuWsAuxpPwEPlXd8oDV1UDZ6raB22HX71YKyOtlvi-A54toratb8_w2XZqU5bCHji2r6xWkUwuFrje6sqiBBO0EGtmgCn2zlGb9OHxeQpeZk9Pk_uXhKdFllMZFYYzvLcsCoVxjDFU0a5YbnMjFaC0dpwAURzJtJa8FoRXjCeUqCECMkVG6OrTW7v3dcKQixbGzQ0jerArUKZSpnzQpIhd4yuN1R7F4KHuuy9bZVfl5SUP32Wuz4He7GNXVUtmJ38K3AA5xvwqfwS_A7s_i__PU_vFxtR9qZm3yZ8g40</recordid><startdate>20240201</startdate><enddate>20240201</enddate><creator>Cardinali, Federica</creator><creator>Panunzi, Chiara</creator><creator>D'Antonio, Francesco</creator><creator>Khalil, Asma</creator><creator>Spinillo, Arsenio</creator><creator>Arossa, Alessia</creator><creator>Familiari, Alessandra</creator><creator>Pagani, Giorgio</creator><creator>Resta, Serena</creator><creator>Rizzo, Giuseppe</creator><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20240201</creationdate><title>Role of Cerebroplacental Ratio in Predicting the Outcome of Pregnancies Complicated by Diabetes</title><author>Cardinali, Federica ; Panunzi, Chiara ; D'Antonio, Francesco ; Khalil, Asma ; Spinillo, Arsenio ; Arossa, Alessia ; Familiari, Alessandra ; Pagani, Giorgio ; Resta, Serena ; Rizzo, Giuseppe</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c294t-849d5366d3b27dd3a52315d3684dca731fd57e0c5372f75fa0593521e100785a3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2024</creationdate><topic>Birth Weight</topic><topic>Diabetes, Gestational - diagnostic imaging</topic><topic>Female</topic><topic>Fetal Growth Retardation - diagnostic imaging</topic><topic>Gestational Age</topic><topic>Humans</topic><topic>Hypoglycemia</topic><topic>Infant, Newborn</topic><topic>Infant, Small for Gestational Age</topic><topic>Middle Cerebral Artery - diagnostic imaging</topic><topic>Perinatal Death</topic><topic>Pregnancy</topic><topic>Pregnancy Outcome</topic><topic>Premature Birth</topic><topic>Prenatal Diagnosis</topic><topic>Pulsatile Flow</topic><topic>Ultrasonography, Prenatal</topic><topic>Umbilical Arteries - diagnostic imaging</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Cardinali, Federica</creatorcontrib><creatorcontrib>Panunzi, Chiara</creatorcontrib><creatorcontrib>D'Antonio, Francesco</creatorcontrib><creatorcontrib>Khalil, Asma</creatorcontrib><creatorcontrib>Spinillo, Arsenio</creatorcontrib><creatorcontrib>Arossa, Alessia</creatorcontrib><creatorcontrib>Familiari, Alessandra</creatorcontrib><creatorcontrib>Pagani, Giorgio</creatorcontrib><creatorcontrib>Resta, Serena</creatorcontrib><creatorcontrib>Rizzo, Giuseppe</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Fetal diagnosis and therapy</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Cardinali, Federica</au><au>Panunzi, Chiara</au><au>D'Antonio, Francesco</au><au>Khalil, Asma</au><au>Spinillo, Arsenio</au><au>Arossa, Alessia</au><au>Familiari, Alessandra</au><au>Pagani, Giorgio</au><au>Resta, Serena</au><au>Rizzo, Giuseppe</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Role of Cerebroplacental Ratio in Predicting the Outcome of Pregnancies Complicated by Diabetes</atitle><jtitle>Fetal diagnosis and therapy</jtitle><addtitle>Fetal Diagn Ther</addtitle><date>2024-02-01</date><risdate>2024</risdate><volume>51</volume><issue>1</issue><spage>55</spage><epage>65</epage><pages>55-65</pages><issn>1015-3837</issn><issn>1421-9964</issn><eissn>1421-9964</eissn><abstract><![CDATA[Introduction: Our objective was to evaluate the strength of association and diagnostic performance of cerebroplacental ratio (CPR) in predicting the outcome of pregnancies complicated by pre- and gestational diabetes mellitus. Methods: PubMed, Embase, Cochrane, and Google Scholar databases were searched. Inclusion criteria were pregnancies complicated by gestational or pregestational diabetes undergoing ultrasound assessment of CPR. The primary outcome was a composite score of perinatal mortality and morbidity as defined by the original publication. The secondary outcomes included preterm birth gestational age (GA) at birth, mode of delivery, fetal growth restriction (FGR) or small for GA (SGA) newborn, neonatal birthweight, perinatal death (PND), Apgar score <7 at 5 min, abnormal acid-base status, neonatal hypoglycemia, admission to neonatal intensive care unit (NICU). Furthermore, we aimed to perform a number of sub-group analyses according to the type of diabetes (gestational and pregestational), management adopted (diet insulin or oral hypoglycemic agents), metabolic control (controlled vs. non-controlled diabetes), and fetal weight (FGR, normally grown, and large for GA fetuses). Head-to-head meta-analyses were used to directly compare the risk of each of the explored outcomes. For those outcomes found to be significant, computation of diagnostic performance of CPR was assessed using bivariate model. Results: Six studies (2,743 pregnancies) were included. The association between low CPR and adverse composite perinatal outcome was not statistically significant (p = 0.096). This result did not change when stratifying the analysis using CPR cut-off below 10th (p = 0.079) and 5th (p = 0.545) centiles. In pregnancies complicated by GDM, fetuses with a low CPR had a significantly higher risk of birthweight <10th percentile (OR: 5.83, 95% confidence interval [CI] 1.98–17.12) and this association remains significant when using a CPR <10th centile (p < 0.001). Fetuses with low CPR had also a significantly higher risk of PND (OR: 6.15, 95% CI 1.01–37.23, p < 0.001) and admission to NICU (OR 3.32, 95% CI 2.21–4.49, p < 0.001), but not of respiratory distress syndrome (p = 0.752), Apgar score <7 at 5 min (p = 0.920), abnormal acid-base status (p = 0.522), or neonatal hypoglycemia (p = 0.005). These results were confirmed when stratifying the analysis including only studies with CPR <10th centile as a cut-off to define abnormal CPR. However, CPR showed a low diagnostic accuracy for detecting perinatal outcomes. Conclusion: CPR is associated but not predictive of adverse perinatal outcome in pregnancies complicated by gestational diabetes. The findings from this systematic review do not support the use of CPR as a universal screening for pregnancy complication in women with diabetes.]]></abstract><cop>Basel, Switzerland</cop><pmid>37926070</pmid><doi>10.1159/000534483</doi><tpages>11</tpages></addata></record> |
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| subjects | Birth Weight Diabetes, Gestational - diagnostic imaging Female Fetal Growth Retardation - diagnostic imaging Gestational Age Humans Hypoglycemia Infant, Newborn Infant, Small for Gestational Age Middle Cerebral Artery - diagnostic imaging Perinatal Death Pregnancy Pregnancy Outcome Premature Birth Prenatal Diagnosis Pulsatile Flow Ultrasonography, Prenatal Umbilical Arteries - diagnostic imaging |
| title | Role of Cerebroplacental Ratio in Predicting the Outcome of Pregnancies Complicated by Diabetes |
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