Predicting adverse neonatal outcome in severe fetal compromise: a pivotal role for estimated fetal weight Z scores.

OBJECTIVE: To identify significant predictors for adverse neonatal outcome in severe by compromised fetuses.

METHODS: Consecutive premature fetuses at between 25 and 32 weeks' with severe placental insufficiency were examined prospectively. Inclusion criteria were: singletons; normal anatomy; abnormal umbilical artery Doppler pulsatility index; abnormal cerebroplacental ratio; middle cerebral artery pulsatility index (PI)
RESULTS: Univariate analysis for all potential predicting variables was performed. EFW Z score index showed the strongest association with mortality and there was no fetal death or Retinopathy of Prematurity in the group with EFW Z-score index below lower limit. There was no case of Cystic Periventricular Leukomalatia in these analyses. The area under receiver-operator characteristic curve was significant for EFW Z-score index.

CONCLUSION: Our study suggests that EFW Z score is the strongest predictor of adverse neonatal outcome in severely compromised fetuses.