Correlation of maternal body mass index with umbilical artery Doppler in pregnancies complicated by fetal growth restriction and associated outcomes

Abstract

Objective To evaluate the correlation between umbilical artery (UA) Doppler and its feasibility across categories of maternal body mass index (BMI; calculated as weight in kilograms divided by the square of height in meters) in the presence of fetal growth restriction (FGR). Methods A total of 1074 singleton pregnancies with suspected FGR on ultrasound examination between 24+0 and 36+0 weeks of pregnancy were reviewed. Evaluation of the UA Doppler was performed at 1‐ to 2‐weekly intervals. Abnormal UA Doppler findings and delivery outcomes were compared between the different maternal BMI categories. Results Increased UA pulsatility index (PI >95th centile) was reported in 81% of obese class II patients (BMI 35–39.9) compared with a 46% incidence in the remaining categories, normal (BMI <24.9), overweight (BMI 25–29.9), and obese class I (BMI 30–34.9) (P = 0.001). In absent or reversed end diastolic flow (AEDF/REDF) we found an increasing incidence across the BMI categories (4%–25%) (P < 0.001). Higher maternal BMI was associated with lower birthweights and higher cesarean section rates. Increasing maternal BMI did not affect successful assessment of UA Doppler. Conclusion There is a positive correlation between increasing maternal BMI and abnormal UA Doppler findings in FGR. Maternal BMI may be considered as an additional risk factor when evaluating UA Doppler for placental insufficiency.

Dynamic growth changes in fetal growth restriction using serial ultrasonographic biometry and umbilical artery doppler: The multicenter PORTO study

“…It has been reported that high‐risk fetuses with FGR will usually result in abnormal Doppler findings, most commonly seen in the umbilical artery 5,16 . The findings of the present study concur with this, the evolving low risk of the growers subgroup demonstrated by the normal umbilical artery Dopplers (Table 2).…”

“…However, this is a limitation in our study as maternal BMI was only recorded at recruitment, and changes in weight were not accounted for. Low pregnancy weight and poor weight gain have been reported to negatively affect fetal growth, 7 as does high maternal BMI, 16,17 but this was not assessed among the “growers.” It may be valuable to examine this aspect of maternal weight gain in future studies to assess its influence on fetal growth dynamics.…”

“…to negatively affect fetal growth, 7 as does high maternal BMI, 16,17 but this was not assessed among the "growers." It may be valuable to examine this aspect of maternal weight gain in future studies to assess its influence on fetal growth dynamics.…”

Pregnancy course and outcomes in patients with non-insulin dependent gestational diabetes mellitus: An observational cohort study

“…Воспалительные и окислительные изменения в плаценте приводят к снижению митохондриального дыхания, выработке аденозинтрифосфорной кислоты в трофобласте и нарушению ее функции. Соответственно, материнское ожирение может рассматриваться как фактор риска ПН [22][23][24]. С другой стороны, исследование L. Sawant et al демонстрирует, что низкий индекс массы тела у беременных приводит к уменьшению диаметра и массы плаценты.…”