Sex‐specific reference ranges of cerebroplacental and umbilicocerebral ratios: longitudinal study

Acharya, Ganesh; Ebbing, Cathrine; Karlsen, Henriette Odland; Kiserud, Torvid; Rasmussen, Svein

doi:10.1002/uog.21870

Cited by 23 publications

(36 citation statements)

References 55 publications

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“…We appreciate the external scrutiny and testing of our results 1 that Dr Morales‐Roselló et al . have undertaken and reported in their Correspondence.…”

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confidence: 79%

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Acharya

Ebbing

Karlsen

et al. 2020

Ultrasound in Obstet & Gyne

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We appreciate the external scrutiny and testing of our results 1 that Dr Morales-Roselló et al. have undertaken and reported in their Correspondence. We would like to comment as follows:The results of their analysis actually agree with our results. In their analysis, which was restricted to pregnancies ≥ 32 gestational weeks, they found no sex-related difference in the cerebroplacental ratio (CPR). Our study included a wider gestational age range (19-41 weeks). We found that the difference in CPR between male and female fetuses was more pronounced earlier in gestation (P = 0.006), but, in agreement with the findings of Morales-Roselló et al., the difference was not significant after 33 weeks (P = 0.42), a pattern that is well illustrated in figure 2 of our article.We compared gestational-age specific Z-scores of transformed CPR values. Although we disagree that our finding of higher CPR in male fetuses is caused by an inferior analysis method, we reanalyzed our data, adding sex to the multilevel model which describes the association with gestational age. Adding sex significantly improved the fit to the data overall (P < 0.04, log likelihood test) and for fetuses < 33 gestational weeks (P = 0.03), but not for fetuses ≥ 33 weeks (P > 0.5). Assessing maternal and fetal factors that might influence the association between fetal sex and CPR was beyond the scope of our study, which had set out to provide reference ranges with reliable extreme centiles (reflected in their narrow 95% CI), terms for conditioning to refine longitudinal monitoring for fetuses with undisclosed sex, and, if significant differences between sexes were found, sex-specific ranges and terms.

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“…We appreciate the external scrutiny and testing of our results 1 that Dr Morales‐Roselló et al . have undertaken and reported in their Correspondence.…”

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confidence: 79%

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Acharya

Ebbing

Karlsen

et al. 2020

Ultrasound in Obstet & Gyne

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“…In this article, we report normative data on Q-based indices of fetal brain sparing. Data on PI-based CPR and UCR from the same study population that have been partly used in a previous report 16 The inner diameters of the UV and SVC were measured using two-dimensional ultrasonography in an insonation perpendicular to the vessel. The UV was measured at a free-floating loop of the umbilical cord and the SVC was measured at its inlet to the right atrium in a long axis view.…”

Section: Materials and Me Thodsmentioning

confidence: 99%

Volume blood flow‐based indices of fetal brain sparing in the second half of pregnancy: A longitudinal study

Stefopoulou

Johnson

Wilsgaard

et al. 2020

Acta Obstet Gynecol Scand

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“…In their work, Acharya et al . developed CPR references according to fetal sex 2 , suggesting a possible role in the surveillance of fetal wellbeing. Although we also consider that fetal sex could ‘ a‐priori ’ justify variations in CPR and we appreciate very much the authors' work, we respectfully disagree with the methodology applied and the results obtained, according to the following postulates.…”

Section: Figurementioning

confidence: 99%