Outcomes of pregnancies with varying levels of nuchal translucency measurements: A population‐based retrospective study in Ontario, Canada
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Wiley
2024
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| _version_ | 1867018207885262848 |
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| author | Kara Bellai‐Dussault Shelley D. Dougan Deshayne B. Fell Carolina Lavin Venegas Julian Little Lynn Meng Nan Okun Mark Walker Christine M. Armour Beth K. Potter |
| author_facet | Kara Bellai‐Dussault Shelley D. Dougan Deshayne B. Fell Carolina Lavin Venegas Julian Little Lynn Meng Nan Okun Mark Walker Christine M. Armour Beth K. Potter Kara Bellai‐Dussault Shelley D. Dougan Deshayne B. Fell Carolina Lavin Venegas Julian Little Lynn Meng Nan Okun Mark Walker Christine M. Armour Beth K. Potter |
| collection | Wiley Open Access |
| contents | Outcomes of pregnancies with varying levels of nuchal translucency measurements: A population‐based retrospective study in Ontario, Canada Kara Bellai‐Dussault Shelley D. Dougan Deshayne B. Fell Carolina Lavin Venegas Julian Little Lynn Meng Nan Okun Mark Walker Christine M. Armour Beth K. Potter Acta Obstetricia et Gynecologica Scandinavica AbstractIntroductionNuchal translucency prenatal ultrasound is widely used to screen for chromosomal abnormalities. An elevated nuchal translucency has been associated with adverse outcomes such as pregnancy loss; however, extant studies investigating these associations have had important limitations, including selection bias. This study aimed to investigate the association between nuchal translucency measurements and pregnancy outcome, specifically, a composite of pregnancy loss, termination, stillbirth, or neonatal death.Material and MethodsThis was a population‐based retrospective cohort study conducted with data from the prescribed perinatal registry in Ontario, Canada, Better Outcomes Registry & Network. All singleton pregnancies with an estimated date of delivery from September 1, 2016, to March 31, 2021, and multiple marker screening including a nuchal translucency were included. Pregnancies with measurements 2.0‐ < 2.5 mm, 2.5‐ < 3.0 mm, 3.0‐ < 3.5 mm, 3.5‐ < 5.0 mm, 5.0‐ < 6.5 mm, and ≥6.5 mm were compared to a reference group with measurements <2.0 mm. We used multivariable modified Poisson regression models with robust variance estimation to estimate associations between nuchal translucency measurement and pregnancy outcome, with adjustment for age at estimated date of delivery and gestational age at screening.ResultsThere were 414 268 singleton pregnancies included in the study. The risk of pregnancy loss, termination, stillbirth, or neonatal death increased with increasing levels of nuchal translucency measurements, with an adjusted risk ratio (aRR) of 11.9 (95% confidence interval (CI) 9.9, 14.3) in the group with measurements 3.5‐ < 5.0 mm. When pregnancies with diagnosed chromosomal abnormalities were excluded, this association remained strong, with an aRR of 6.4 (95% CI 4.8, 8.5). Among pregnancies with a live birth, those with a higher nuchal translucency measurement (>5.0 mm vs. <2.0 mm) were also at increased risk of adverse perinatal outcomes such as admission to the neonatal intensive care unit and APGAR score <7.ConclusionsIn this population‐based study using robust methods to reduce the risk of selection bias, we found that pregnancies with increased nuchal translucency measurements are less likely to result in a live birth, even with the exclusion of chromosomal abnormalities. Pregnancies with increased nuchal translucency measurements that resulted in a live birth may also be at increased risk of adverse perinatal outcomes. 10.1111/aogs.14965 http://creativecommons.org/licenses/by-nc-nd/4.0/ |
| doi_str_mv | 10.1111/aogs.14965 |
| format | Artículo Open Access |
| id | wiley_oa_10_1111_aogs_14965 |
| institution | Wiley Open Access |
| license_str_mv | http://creativecommons.org/licenses/by-nc-nd/4.0/ |
| publishDate | 2024 |
| publisher | Wiley |
| record_format | wiley_oa |
| spellingShingle | Outcomes of pregnancies with varying levels of nuchal translucency measurements: A population‐based retrospective study in Ontario, Canada Kara Bellai‐Dussault Shelley D. Dougan Deshayne B. Fell Carolina Lavin Venegas Julian Little Lynn Meng Nan Okun Mark Walker Christine M. Armour Beth K. Potter Acta Obstetricia et Gynecologica Scandinavica Outcomes of pregnancies with varying levels of nuchal translucency measurements: A population‐based retrospective study in Ontario, Canada Kara Bellai‐Dussault Shelley D. Dougan Deshayne B. Fell Carolina Lavin Venegas Julian Little Lynn Meng Nan Okun Mark Walker Christine M. Armour Beth K. Potter Acta Obstetricia et Gynecologica Scandinavica AbstractIntroductionNuchal translucency prenatal ultrasound is widely used to screen for chromosomal abnormalities. An elevated nuchal translucency has been associated with adverse outcomes such as pregnancy loss; however, extant studies investigating these associations have had important limitations, including selection bias. This study aimed to investigate the association between nuchal translucency measurements and pregnancy outcome, specifically, a composite of pregnancy loss, termination, stillbirth, or neonatal death.Material and MethodsThis was a population‐based retrospective cohort study conducted with data from the prescribed perinatal registry in Ontario, Canada, Better Outcomes Registry & Network. All singleton pregnancies with an estimated date of delivery from September 1, 2016, to March 31, 2021, and multiple marker screening including a nuchal translucency were included. Pregnancies with measurements 2.0‐ < 2.5 mm, 2.5‐ < 3.0 mm, 3.0‐ < 3.5 mm, 3.5‐ < 5.0 mm, 5.0‐ < 6.5 mm, and ≥6.5 mm were compared to a reference group with measurements <2.0 mm. We used multivariable modified Poisson regression models with robust variance estimation to estimate associations between nuchal translucency measurement and pregnancy outcome, with adjustment for age at estimated date of delivery and gestational age at screening.ResultsThere were 414 268 singleton pregnancies included in the study. The risk of pregnancy loss, termination, stillbirth, or neonatal death increased with increasing levels of nuchal translucency measurements, with an adjusted risk ratio (aRR) of 11.9 (95% confidence interval (CI) 9.9, 14.3) in the group with measurements 3.5‐ < 5.0 mm. When pregnancies with diagnosed chromosomal abnormalities were excluded, this association remained strong, with an aRR of 6.4 (95% CI 4.8, 8.5). Among pregnancies with a live birth, those with a higher nuchal translucency measurement (>5.0 mm vs. <2.0 mm) were also at increased risk of adverse perinatal outcomes such as admission to the neonatal intensive care unit and APGAR score <7.ConclusionsIn this population‐based study using robust methods to reduce the risk of selection bias, we found that pregnancies with increased nuchal translucency measurements are less likely to result in a live birth, even with the exclusion of chromosomal abnormalities. Pregnancies with increased nuchal translucency measurements that resulted in a live birth may also be at increased risk of adverse perinatal outcomes. 10.1111/aogs.14965 http://creativecommons.org/licenses/by-nc-nd/4.0/ |
| title | Outcomes of pregnancies with varying levels of nuchal translucency measurements: A population‐based retrospective study in Ontario, Canada |
| topic | Acta Obstetricia et Gynecologica Scandinavica |
| url | https://obgyn.onlinelibrary.wiley.com/doi/10.1111/aogs.14965 |