Biosensor for Detecting Fetal Growth Restriction in a Low-Resource Setting

Abstract

One strategy for improving detection of fetal growth restriction (FGR) is developing biosensors identifying placental dysfunction as a leading pathogenesis for FGR. The aim of this pilot study was to investigate the performance of a biosensor specified to detect placental dysfunction by means of maternal arterial turbulence acoustics in a low-resource setting. A cohort of 147 singleton pregnant women were prospectively followed with double-blinded biosensor tests, sonographic estimation of fetal weight (EFW) and Doppler flow at 26–28, 32–34 and 37–39 weeks of pregnancy. Full term live births with recorded birth weights (BWs) and without major congenital malformations were included. Outcomes were defined as (A) a solitary biometric measure (BW < 3rd centile) and as (B) a biometric measure and contributory functional measure (BW < 10th centile and antenatally detected umbilical artery pulsatility index > 95th centile). Data from 118 women and 262 antenatal examinations were included. Mean length of pregnancy was 40 weeks (SD ± 8 days), mean BW was 3008 g (SD ± 410 g). Outcome (A) was identified in seven (6%) pregnancies, whereas outcome (B) was identified in one (0.8%) pregnancy. The biosensor tested positive in five (4%) pregnancies. The predictive performance for outcome (A) was sensitivity = 0.29, specificity = 0.97, p = 0.02, positive predictive value (PPV) was 0.40 and negative predictive value (NPV) was 0.96. The predictive performance was higher for outcome (B) with sensitivity = 1.00, specificity = 0.97, p = 0.04, PPV = 0.20 and NPV = 1.00. Conclusively, these pilot-study results show future potential for biosensors as screening modality for FGR in a low-resource setting.

Malaria and Helminthic Co-Infection during Pregnancy in Sub-Saharan Africa: A Systematic Review and Meta-Analysis

“…Ensuring adequate access and enforcing adherence to safety and hygiene practices among pregnant women and safeguarding gestational mothers from economically disadvantaged households by creating sustainable access to economic opportunities will be essential to meet the global effort to control, prevent, and eliminate helminthic infections in sub-Saharan Africa [178][179][180][181][182][183][184][185][186]. To meet the 2030 target of successful elimination of helminthic infection, health systems in SSA and their international development partners must enhance the capacity and uptake of promising vaccine technology and innovation to improve maternal outcomes following gestational treatment of intestinal nematodes to help guide clinical decision making [187][188][189][190][191][192][193][194][195][196]. Sustainable and inclusive financing must be in place for the cutting-edge research and prudent innovation to deeply investigate the clinical outcomes of immunogenicity of comorbidity of malaria and helminths among gestational mothers in SSA [197][198][199][200][201][202][203][204][205][206].…”