295 - Utilizing Antenatal Doppler Velocimetry as a Tool for Predicting Outcomes in Small for Gestational Age Newborns

Friday, April 28, 2023

5:15 PM – 7:15 PM ET

Poster Number: 295
Publication Number: 295.132

Anna Weinstein, Joseph M. Sanzari Children's Hospital Hackensack University Medical Center, Hackensack, NJ, United States; Kimberly Murphy, Hackensack University Medical Center, Sparkill, NY, United States; Soindos Abdah, Hackensack Meridian School of Medicine, Fairview, NJ, United States; Tara Lozy, Hackensack Meridian School of Medicine, Hackensack, NJ, United States; Antonia Francis, Hackensack Meridian School of Medicine, Hackensack, NJ, United States; jesus alvarez-Perez, Hackensack Meridian School of Medicine, Hackensack, NJ, United States; Marwa Khalil, Joseph M. Sanzari Children's Hospital Hackensack University Medical Center, Hackensack, NJ, United States

Presenting Author(s)

Anna Weinstein, DO, MS

Resident Physician
Joseph M. Sanzari Children's Hospital Hackensack University Medical Center
Hackensack, New Jersey, United States

Background: Fetal growth restriction (FGR) is a leading cause of perinatal morbidity. The underlying etiologies of FGR are similar in that they cause uteroplacental hypoperfusion, which leads to chronic fetal hypoxia, negatively affecting fetal development and postnatal sequelae. Antenatal ultrasound surveillance with doppler velocimetry allows perinatologists to monitor the progression of FGR. While abnormal umbilical artery doppler studies have been implicated in poor neonatal outcomes, their utility in predicting specific neonatal morbidity has not yet been investigated.

Objective: To identify antenatal sonographic findings amongst FGR fetuses that can predict postnatal complications in the small-for-gestational-age (SGA) neonate.

Design/Methods: A retrospective chart review of SGA neonates was performed. Corresponding maternal antenatal sonograms were reviewed. Pregnancies affected by known chromosomal abnormality were excluded. Group comparisons were performed using student t-test for continuous variables and chi-square test for categorical variables with a significance threshold of 0.05.

Results: Eighty four SGA neonates were diagnosed with FGR antenatally. Maternal chart review identified a heterogeneous racial distribution. 26% of mothers were of advanced maternal age. 86% were at least overweight, and 40% met criteria for obesity. 30% of SGA neonates required total parenteral nutrition (TPN) postnatally (n=26), 50% of whom had abnormal umbilical artery dopplers on antenatal ultrasound (n=13; p < 0.05). 13% of the SGA neonates were noted to have residual feeds (n=6), 83% of whom had abnormal umbilical artery dopplers on antenatal ultrasound (n=5; p < 0.05). 60% of SGA neonates had hyperbilirubinemia (n=46), 33% of whom had abnormal umbilical artery dopplers (n=15; p< 0.05). After adjusting for gestational age, the average length of stay for SGA neonates who had abnormal umbilical artery dopplers was 19.5, whereas the average length of stay for SGA neonates without doppler abnormalities was 4 days (p< 0.05).

Conclusion(s):
The preliminary results of this study demonstrate that FGR with abnormal umbilical artery dopplers is predictive of neonatal feeding intolerance, hyperbilirubinemia, and increased length of hospital admission. While a limitation of this study is small sample size, future investigative efforts are warranted to determine the reliability of our results in a higher powered database. Such research could inspire the development of antenatal sonographic markers for postnatal complications, optimizing informed care and prenatal counseling of pregnancies affected by FGR.