Poster Session 2
Category: Ultrasound/Imaging
Poster Session 2
Nikolas Bletnitsky, BS
Medical Student
Columbia University Medical Center
Brooklyn, New York, United States
Helen B. Gomez Slagle, MD, RDMS
Clinical Fellow
Columbia University Irving Medical Center
New York, New York, United States
Shai Bejerano, MS
Data Analyst
Columbia University Irving Medical Center
New York, New York, United States
Uma M. Reddy, MD, MPH
Professor
Columbia University Irving Medical Center
New York, New York, United States
Maria Andrikopoulou, MD
Assistant Professor
Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Columbia University Irving Medical Center
New York, New York, United States
Olivia F. Schulist
Columbia University Irving Medical Center
New York, New York, United States
While abdominal circumference (AC)< 10% is included in the definition of fetal growth restriction, its association with neonatal outcomes is unclear. We evaluated the association between isolated AC< 10%, estimated fetal weight (EFW)< 10%, and neonatal outcomes.
Study Design:
This was a retrospective cohort of singleton pregnancies at a tertiary care center from 2020–2023. Fetal anomalies, missing data, and EFW > 90% were excluded. Study arms were EFW and AC 10-90%, EFW< 10 and AC 10-90%, EFW 10-90% and AC< 10% (isolated AC< 10%), and EFW and AC< 10%. The primary outcome was serious composite neonatal morbidity (SCNM): acidosis, NICU admission, or neonatal death. Categorical variables were analyzed using Chi-squared or Fisher’s exact test; continuous variables with ANOVA or Kruskal-Wallis. Logistic regression adjusted for maternal age, race, hypertension, pregestational diabetes, and pre-pregnancy BMI.
Results:
A total of 8,870 patients met inclusion criteria. The rate of isolated AC< 10% was 3.2%. An EFW< 10% was associated with the highest SCNM risk, regardless of AC (33.3% vs 9.6%, p < 0.001) (Table 1). Fetuses with an isolated AC< 10% had higher SCNM compared to normally grown fetuses (13.2% vs 9.6%, p < 0.001). An EFW< 10% was also associated with the highest rate of neonatal death (5.6% vs 0.1%, p < 0.001). An isolated AC< 10% was associated with a higher rate of neonatal death compared to normally grown fetuses (0.4% vs 0.1%, p < 0.001). The adjusted composite outcome was higher among EFW< 10% regardless of AC (OR 3.93, CI 1.87-8.28, p=0.0003) while isolated AC< 10% was not associated with higher rate of SCNM after adjusting for confounders (Table 2).
Conclusion:
In one of the largest cohorts linking prenatal ultrasound with neonatal outcomes, EFW< 10% was strongly associated with SCNM and neonatal death, regardless of AC. Although isolated AC< 10% showed increased unadjusted risk, it was not independently associated with adverse outcomes after adjustment. EFW< 10% appears to be a more reliable predictor of neonatal risk than isolated AC< 10%.