Clinical prediction in early pregnancy of infants small for gestational age by customised birthweight centiles: findings from a healthy nulliparous cohort

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dc.contributor.author McCowan, Lesley M. E.
dc.contributor.author Thompson, John M. D.
dc.contributor.author Taylor, Rennae S.
dc.contributor.author North, Robyn A.
dc.contributor.author Poston, Lucilla
dc.contributor.author Baker, Philip N.
dc.contributor.author Myers, Jenny
dc.contributor.author Roberts, Claire T.
dc.contributor.author Dekker, Gustaaf A.
dc.contributor.author Simpson, Nigel A. B.
dc.contributor.author Walker, James J.
dc.contributor.author Kenny, Louise C.
dc.date.accessioned 2016-02-17T11:45:32Z
dc.date.available 2016-02-17T11:45:32Z
dc.date.issued 2013
dc.identifier.citation McCowan LME, Thompson JMD, Taylor RS, North RA, Poston L, Baker PN, et al. (2013) Clinical Prediction in Early Pregnancy of Infants Small for Gestational Age by Customised Birthweight Centiles: Findings from a Healthy Nulliparous Cohort. PLoS ONE 8(8): e70917. doi:10.1371/journal.pone.0070917 en
dc.identifier.volume 8 en
dc.identifier.issued 8 en
dc.identifier.issn 1932-6203
dc.identifier.uri http://hdl.handle.net/10468/2369
dc.identifier.doi 10.1371/journal.pone.0070917
dc.description.abstract Objective: Small for gestational age (SGA) infants comprise up to 50% of all stillbirths and a minority are detected before birth. We aimed to develop and validate early pregnancy predictive models for SGA infants. Methods: 5628 participants from SCOPE, a prospective study of nulliparous pregnant women, were interviewed at 15 +/- 1 weeks' gestation. Fetal anthropometry, uterine and umbilical Doppler studies were performed at 20 +/- 1 weeks'. The cohort was divided into training (n = 3735) and validation datasets (n = 1871). All-SGA (birthweight,10th customised centile), Normotensive-SGA (SGA with normotensive mother) and Hypertensive-SGA (SGA with mother who developed hypertension) were the primary outcomes. Multivariable analysis was performed using stepwise logistic regression firstly using clinical variables and then with clinical and ultrasound variables. Receiver operator curves were constructed and areas under the curve (AUC) calculated. Results: 633 infants (11.3%) in the whole cohort were SGA; 465 (8.3%) Normotensive-SGA and 165 (3.0%) Hypertensive-SGA. In the training dataset risk factors for All- SGA at 1561 weeks' included: family history of coronary heart disease, maternal birthweight <3000 g and 3000 g to 3499 g compared with >= 3500 g, >12 months to conceive, university student, cigarette smoking, proteinuria, daily vigorous exercise and diastolic blood pressure >= 80. Recreational walking >= 4 times weekly, rhesus negative blood group and increasing random glucose were protective. AUC for clinical risk factors was 0.63. Fetal abdominal or head circumference z scores <10th centile and increasing uterine artery Doppler resistance at 20 +/- 1 weeks' were associated with increased risk. Addition of these parameters increased the AUC to 0.69. Clinical predictors of Normotensive and Hypertensive-SGA were sub-groups of All-SGA predictors and were quite different. The combined clinical and ultrasound AUC for Normotensive and Hypertensive-SGA were 0.69 and 0.82 respectively. Conclusion: Predictors for SGA of relevance to clinical practice were identified. The identity and predictive potential differed in normotensive women and those who developed hypertension. en
dc.description.sponsorship Foundation for Research Science and Technology, New Zealand (New Enterprise Research Fund (EM 04-05/03)); Health Research Council, New Zealand (04/198); Government of South Australia (Premier's Science and Research Fund); Biotechnology and Biological Sciences Research Council, United Kingdom (GT084); National Health Service, United Kingdom (NEAT FSD025); University of Manchester (Proof of Concept Funding); Health Research Board, Ireland (CSA/2007/2) en
dc.format.mimetype application/pdf en
dc.language.iso en en
dc.publisher Public Library of Science en
dc.rights © 2013 McCowan et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited en
dc.rights.uri http://creativecommons.org/licenses/by/4.0/ en
dc.subject International prospective cohort en
dc.subject Hypertensive disorders en
dc.subject Fetal growth en
dc.subject 1st trimester prediction en
dc.subject Preeclampsia en
dc.subject Risk en
dc.subject Exercise en
dc.subject Restriction en
dc.subject Management en
dc.subject Outcomes en
dc.title Clinical prediction in early pregnancy of infants small for gestational age by customised birthweight centiles: findings from a healthy nulliparous cohort en
dc.type Article (peer-reviewed) en
dc.internal.authorcontactother Louise C. Kenny, Obstetrics and Gynaecology, Cork, Ireland. +353-21-490-3000 Email: l.kenny@ucc.ie en
dc.internal.availability Full text available en
dc.description.version Published Version en
dc.internal.rssid 243941180
dc.internal.wokid WOS:000324465000154
dc.contributor.funder Foundation for Research, Science and Technology, New Zealand en
dc.contributor.funder Health Research Council, New Zealand en
dc.contributor.funder Evelyn Bond Fund, New Zealand en
dc.contributor.funder Auckland District Health Board Charitable Trust, New Zealand en
dc.contributor.funder Premier’s Science and Research Fund, Australia en
dc.contributor.funder Government of South Australia en
dc.contributor.funder Guy’s and St Thomas’ Charity, United Kingdom en
dc.contributor.funder Tommy's Baby Charity en
dc.contributor.funder Biotechnology and Biological Sciences Research Council en
dc.contributor.funder National Health Service, United Kingdom en
dc.contributor.funder University of Manchester, United Kingdom en
dc.contributor.funder National Institute for Health Research, United Kingdom en
dc.contributor.funder Cerebra, United Kingdom en
dc.contributor.funder Health Research Board en
dc.description.status Peer reviewed en
dc.identifier.journaltitle PLOS ONE en
dc.internal.IRISemailaddress l.kenny@ucc.ie en
dc.identifier.articleid e70917


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© 2013 McCowan et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited Except where otherwise noted, this item's license is described as © 2013 McCowan et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited
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