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Recording available 2/16-5/2
Recording available 2/16-5/2
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Poster Session 2

Category: Ultrasound/Imaging

Poster Session 2

(567) Association Between Cerebroplacental Ratio and Placenta Regardless of Birthweight: Secondary Analysis of the IMPACT-BCN Trial

Wednesday, February 11, 2026
3:30 PM - 5:00 PM  

    Submitting Author and Presenting Author(s)

  • Lina Youssef, MD, PhD

    Postdoctoral researcher
    BCNatal – Barcelona Center for Maternal-Fetal and Neonatal Medicine (Hospital Clínic and Hospital Sant Joan de Deu), IDIBAPS, University of Barcelona
    Barcelona, Catalonia, Spain

    • Coauthor(s)

  • Rommy H. Novoa, MD, MSc (she/her/hers)

    Research Fellow
    BCNatal – Barcelona Center for Maternal-Fetal and Neonatal Medicine (Hospital Clínic and Hospital Sant Joan de Deu), IDIBAPS, University of Barcelona
    Barcelona, Catalonia, Spain

  • Ohad Houri, MD, MSc (he/him/his)

    Doctor
    BCNatal Fetal Medicine Research Center
    BARCELONA, Catalonia, Spain

  • GF

    Giulia Ferrante, N/A

    BCNatal – Barcelona Center for Maternal-Fetal and Neonatal Medicine (Hospital Clínic and Hospital Sant Joan de Deu), IDIBAPS, University of Barcelona
    Barcelona, Catalonia, Spain

  • AP

    Arianna Pizzetti

    BCNatal – Barcelona Center for Maternal-Fetal and Neonatal Medicine (Hospital Clínic and Hospital Sant Joan de Deu), IDIBAPS, University of Barcelona
    Barcelona, Catalonia, Spain

  • RC

    Roberta Castellani

    BCNatal – Barcelona Center for Maternal-Fetal and Neonatal Medicine (Hospital Clínic and Hospital Sant Joan de Deu), IDIBAPS, University of Barcelona
    Barcelona, Catalonia, Spain

  • LB

    Leticia Benitez, MD

    BCNatal – Barcelona Center for Maternal-Fetal and Neonatal Medicine (Hospital Clínic and Hospital Sant Joan de Deu), IDIBAPS, University of Barcelona
    Barcelona, Catalonia, Spain

  • IC

    Irene Casas, MD

    BCNatal – Barcelona Center for Maternal-Fetal and Neonatal Medicine (Hospital Clínic and Hospital Sant Joan de Deu), IDIBAPS, University of Barcelona, Barcelona, Spain.
    Barcelona, Catalonia, Spain

  • MG

    Mariona Genero, MD

    BCNatal – Barcelona Center for Maternal-Fetal and Neonatal Medicine (Hospital Clínic and Hospital Sant Joan de Deu), IDIBAPS, University of Barcelona
    Barcelona, Catalonia, Spain

  • FC

    Francesca Crovetto, MD, PhD

    BCNatal – Fetal Medicine Research Center (Hospital Clínic and Hospital Sant Joan de Déu), Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS)
    Barcelona, Catalonia, Spain

  • EG

    Eduard Gratacós, MD, PhD

    Hospital Clínic Barcelona
    BARCELONA, Catalonia, Spain

  • FC

    Fatima Crispi, MD, PhD

    Hospital Clínic de Barcelona
    BARCELONA, Catalonia, Spain

Objective:
To evaluate the association between cerebroplacental ratio (CPR) and placental histopathology, independent of estimated fetal weight (EFW), in fetuses from high-risk pregnancies.

Study Design:

This was a secondary analysis of the IMPACT-BCN randomized clinical trial, including 707 singleton pregnancies at high risk for small-for-gestational-age (SGA) outcomes, defined by an EFW and birthweight below the 10th centile. At 33–34 weeks’ gestation, fetal ultrasound assessments were performed to obtain EFW and CPR, calculated as the ratio of the middle cerebral artery to umbilical artery pulsatility indices. An abnormal CPR was defined as < 5th centile. At delivery, placental weight and histopathological lesions were recorded and categorized as vascular (maternal/fetal), immune-inflammatory, or other, following the 2014 Amsterdam Placental Workshop Group Consensus criteria.


Results:

Placental characteristics were analyzed across four groups: appropriate-for-gestational-age (AGA) fetuses with normal CPR (n=554) or abnormal CPR (n=21), and SGA fetuses with normal CPR (n=112) or abnormal CPR (n=20). Placental weight was significantly lower in both SGA groups compared to AGA groups, regardless of CPR status (315±83 g and 362±63 g vs. 449±99 g and 462±92 g, respectively). No significant differences were observed among groups for vascular or infectious lesions. However, immune-inflammatory lesions were significantly more prevalent in SGA fetuses (with and without abnormal CPR) and in AGA fetuses with abnormal CPR, compared to AGA fetuses with normal CPR (25%, 17%, and 28.6% vs. 9.4%, respectively; p=0.002).


Conclusion:

An abnormal CPR in the third trimester is associated with an increased prevalence of placental immune lesions, independent of fetal growth status. These findings highlight the potential role of CPR as a marker of placental immune dysregulation beyond fetal size assessment.