Publication
First-Trimester Screening and Small for Gestational Age in Twin Pregnancies: a Single Center Cohort Study.
| dc.contributor.author | Queirós, Alexandra | |
| dc.contributor.author | Bernardo, Ana | |
| dc.contributor.author | Rijo, Cláudia | |
| dc.contributor.author | Carocha, Ana | |
| dc.contributor.author | Ferreira, Leonor | |
| dc.contributor.author | Martins, Ana Teresa | |
| dc.contributor.author | Cohen, Álvaro | |
| dc.contributor.author | Alves, Marta | |
| dc.contributor.author | Papoila, Ana Luísa | |
| dc.contributor.author | Simões, Teresinha | |
| dc.date.accessioned | 2025-07-24T09:36:15Z | |
| dc.date.available | 2025-07-24T09:36:15Z | |
| dc.date.issued | 2025-01 | |
| dc.description.abstract | Objective: This study aimed to investigate the association between maternal factors and first-trimester biophysical and biochemical markers with small for gestational age (SGA) neonates in twin pregnancies (TwPs). Methods: Single-center retrospective cohort study of TwPs followed from January 2010 to December 2022 at a tertiary perinatal center, Portugal. Maternal and pregnancy characteristics, mean arterial pressure, pregnancy-associated plasma protein-A (PAPP-A), β-human chorionic gonadotropin (β-HCG), and uterine artery pulsatility index (UtA-PI) were analyzed. Univariable, multivariable logistic regression (LR) and receiver-operating characteristic curve analyses were performed. The main outcome measures considered were: SGA < 3rd, < 5th and < 10th percentile, the composite outcome of SGA combined with preterm birth (PTB) (< 32, < 34, and < 36 weeks). Results: 572 TwPs were included, 450 (78.7%) DC and 122 (21.3%) MC. TwPs affected with SGA < 3rd, < 5th or < 10th percentiles were 120/572 (20.9%), 157/572 (27.4%) and 190/572 (33.2%), respectively. SGA < 3rd percentile was associated with a higher rate of PTB, 59.0% of cases < 32 weeks, OR 6.4 (95% CI: 3.2-12.7, p < 0.001). Shorter maternal height, UtA-PI ≥ 95th percentile, and low PAPP-A were identified as significant independent risk factors associated with SGA and SGA combined with PTB. The best LR model was obtained for the composite outcome SGA < 3rd percentile and PTB < 32 weeks, with an AUC of 0.834, a sensitivity rate of 77%, and a false positive rate of 17%. Conclusion: The majority of pregnancies at risk for SGA combined with prematurity can be detected in the first trimester. However, larger datasets are necessary to develop robust predictive models. | eng |
| dc.identifier.citation | Arch Gynecol Obstet . 2025 Jan;311(1):43-53 | |
| dc.identifier.doi | 10.1007/s00404-024-07884-6 | |
| dc.identifier.other | 39724362 | |
| dc.identifier.uri | http://hdl.handle.net/10400.17/5113 | |
| dc.language.iso | en | |
| dc.peerreviewed | yes | |
| dc.publisher | Springerlink | |
| dc.rights.uri | http://creativecommons.org/licenses/by-nc/4.0/ | |
| dc.subject | Aspirin prophylaxis | |
| dc.subject | Fetal growth restriction | |
| dc.subject | First-trimester screening | |
| dc.subject | Preterm birth | |
| dc.subject | Small for gestational age | |
| dc.subject | Twin pregnancies | |
| dc.title | First-Trimester Screening and Small for Gestational Age in Twin Pregnancies: a Single Center Cohort Study. | por |
| dc.type | text | |
| dspace.entity.type | Publication | |
| oaire.citation.endPage | 53 | |
| oaire.citation.issue | 11 | |
| oaire.citation.startPage | 43 | |
| oaire.citation.volume | 311 | |
| oaire.version | http://purl.org/coar/version/c_970fb48d4fbd8a85 |