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Poster Session 4

Category: Antepartum Fetal Assessment

Poster Session 4

(1270) Umbilical Cord Blood Gases as Indicators of Fetal Compromise in Preterm Preeclampsia with Growth-Restricted Fetuses

Thursday, February 12, 2026

3:30 PM - 5:00 PM

Submitting Author and Presenting Author(s)

Stephanie Schreiber-Gonzalez, DO (she/her/hers)

Ascension Healthcare
Clarendon Hills, Illinois, United States

Coauthor(s)

RM

Renata Mukai, MD

University of Illinois at Chicago
Chicago, Illinois, United States
CH

Calla Holmgren, MD

Physician
Advocate Medical Group
Chicago, Illinois, United States
SW

Sydney Whalen, BS

Medical Student
University of Illinois at Chicago
University of Illinois at Chicago, Illinois, United States
KS

Karlie Snead, MD

Ascension Healthcare
Ascension, Illinois, United States
AW

Alexandra Wilson, MD

Advocate Health Care
Advocate, Illinois, United States
Rachel K. Harrison, MD (she/her/hers)

Clinical Professor Maternal-Fetal Medicine
Department of Maternal-Fetal Medicine, Advocate Aurora Health
Chicago, Illinois, United States

Objective:
To assess severity of umbilical artery Doppler (UAD) abnormalities and correlation to umbilical cord blood gases in pregnancies complicated by fetal growth restriction (FGR) and preeclampsia < 34 weeks.

Study Design:
Retrospective cohort study of 199 patients complicated by FGR and preterm preeclampsia < 34 weeks admitted within a large hospital system between 12/2020 and 12/2023. Pregnancies complicated by lethal fetal anomalies were excluded. The pregnancies were stratified by UAD findings: normal, elevated resistance, and absent/reversed end-diastolic flow (AEDF/REDF). Those with normal UAD were used as the comparison group. The primary outcomes assessed were arterial cord gas components including the arterial pH, pCO₂, pO₂< 25, and base excess. Statistical analysis was performed using Stata version 17.0 via ANOVA, chi2 or fisher’s exact, and linear and logistic regression to control for confounders.

Results:
199 pregnancies met inclusion criteria. UAD were normal in 51.2% (n=102), elevated in 28.6% (n=57), and AEDF/REDF in 20.1% (n=40). Increasing UAD severity was associated with earlier gestational age (GA) at FGR diagnosis, estimated fetal weight (EFW) < 3rd percentile (p = 0.032), and earlier delivery (p=0.008). Other baseline characteristics were similar across groups . With regard to the primary outcome, arterial cord pH was not associated with UAD severity on univariate analysis (normal 7.26±0.07, elevated 7.25±0.09, AEDF/REDF UAD 7.21±0.07) (p=0.064). In regression analysis AEDF/REDF was associated with a lower pH [OR -0.05, 95%CI(-0.09 to -0.01)], higher pCO₂ [5.99, 95%CI(0.07 to 11.92)], and increased likelihood of pO₂ < 25 [2.07, 95%CI(1.96 to 6.68)]. When controlling for confounders including GA at FGR diagnosis, GA at delivery, EFW < 3rd percentile, and steroid exposure, lower arterial pH remained associated with AEDF/REDF [aOR -0.05, 95%CI(-0.09 to -0.01)](see Table 1).

Conclusion:
Severe UAD abnormalities in pregnancies complicated by preterm preeclampsia and FGR are linked to worse umbilical cord gases, with AEDF/REDF UAD demonstrating worse arterial pH.