Objective

To assess the external validity and clinical relevance of current references for umbilical artery resistance index (UA RI) in daily practice.

Methods

Retrospective cross-sectional single center study including all UA RI measurements between 22 and 40 gestational weeks (GW) from distinct patients between 2014 and 2022. Patients with normal pregnancies and normal neonatal outcomes that had an UA RI measurement between 2014 and 2019 were used to calculate reference ranges. The established reference for the 95^th centile was compared to two current references. The clinical relevance of the established reference was tested by comparing neonatal outcomes according to the 95th percentile among the consecutive distinct patients between 2020 and 2022.

Results

Among the 13342 consecutive distinct patients with a singleton pregnancy that had an UA RI measurement between 22 and 40 GW between 2014 and 2022, 5298 patients were included to establish the reference ranges, and 3634 patients to validate these ranges. For each gestational age, the established references were similar to current references. Using the established references, the proportion of patients presenting an UA RI>95^th percentile among the patients with normal pregnancies in the validation population was comparable to the proportion when using the two current references. Among the validation population, 268 patients (7.4 %) (95%CI[6.5-8.2]) presented an UA RI ≥ 95th percentile. Of these 268 patients, 67.9% had a SGA newborn (versus 19.2%, p<0.001) and 59% a preterm birth (versus 13.9%, p<0.001).

Conclusions

The reference range obtained from daily practice is clinically relevant and similar to current references.

中文翻译：

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评估日常实践中脐带多普勒阻力指数参考的外部有效性和临床相关性

客观的

评估当前脐动脉阻力指数 (UA RI) 参考文献在日常实践中的外部有效性和临床相关性。

方法

回顾性横断面单中心研究，包括 2014 年至 2022 年期间不同患者在 22 至 40 孕周 (GW) 之间的所有 UA RI 测量。2014 年至 2019 年间进行 UA RI 测量的正常妊娠和新生儿结局正常的患者被用来计算参考范围。^{将建立的 95世纪}参考值与两个当前参考值进行比较。通过根据 2020 年至 2022 年连续不同患者的第 95 个百分位数比较新生儿结局，测试了既定参考的临床相关性。

结果

在 2014 年至 2022 年间，连续 13342 名 UA RI 测量值在 22 至 40 GW 之间的不同单胎妊娠患者中，纳入了 5298 名患者来建立参考范围，并纳入了3634名患者来验证这些范围。对于每个胎龄，建立的参考文献与当前参考文献相似。使用已建立的参考值，验证人群中正常妊娠患者中 UA RI>95% 的患者比例^与使用两个当前参考值时的比例相当。在验证人群中，268 名患者 (7.4%) (95%CI[6.5-8.2]) 的 UA RI ≥ 95%。在这 268 名患者中，67.9% 患有 SGA 新生儿（相对于 19.2%，p<0.001），59% 患有早产（相对于 13.9%，p<0.001）。

结论

从日常实践中获得的参考范围具有临床相关性并且与当前参考值相似。