SynthesisBJOG : an international journal of obstetrics and gynaecology2021
Cerebroplacental ratio in predicting adverse perinatal outcome: a meta-analysis of individual participant data.
Synthesis in BJOG : an international journal of obstetrics and gynaecology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 18 papers, 4 of them syntheses that pooled it.
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Who cites it
18 citing papers in PubMed, 4 syntheses or guidelines pooled it.
- Predictive models for adverse pregnancy outcomes in fetal growth restriction: a systematic review and meta-analysis.BMC pregnancy and childbirth · 2026Pooled it
- The predictive value of abnormal uteroplacental and fetal Doppler indices for adverse perinatal outcomes in hypertensive disorders of pregnancy: a systematic review and meta-analysis.Frontiers in medicine · 2026Pooled it
- Peripartum fetal Doppler sonography and perinatal outcome: a systematic review and meta-analysis.BMC pregnancy and childbirth · 2025Pooled it
- Cerebroplacental ratio in predicting adverse perinatal outcome: a meta-analysis of individual participant data.BJOG : an international journal of obstetrics and gynaecology · 2021Pooled it
- Cerebroplacental ratio and middle cerebral artery doppler indices as associations with maternal and neonatal outcomes in term pregnancies undergoing labor induction or augmentation: A cross-sectional study.European journal of obstetrics & gynecology and reproductive biology: X · 2026Article
- Longitudinal Assessment of Third-Trimester Fetal Biometry and Cerebroplacental Ratio for Predicting Adverse Perinatal Outcomes in an Unselected Obstetric Population: A Prospective Cohort Study.Journal of clinical medicine · 2026Article
- Pre-delivery prediction of vaginal delivery in late-onset foetal growth restriction: development and internal validation of a model with decision curve analysis and bedside calculator.Archives of gynecology and obstetrics · 2026Article
- Prediction of Adverse Perinatal Outcome in Monochorionic Twin Pregnancy Using Fetal Biometry and Doppler Data: A Multicentre Cohort Study.BJOG : an international journal of obstetrics and gynaecology · 2026Article
- Does gestational age influence the predictive accuracy of the cerebroplacental ratio for intrapartum fetal compromise?AJOG global reports · 2026Article
- Predictors of intensive care unit admission in posterior reversible encephalopathy syndrome patients with preeclampsia or eclampsia: a 10-year retrospective study.BMC pregnancy and childbirth · 2026Article
- Superior vena cava blood flow and Doppler indices of brain sparing in late onset fetal growth restriction.Scientific reports · 2025Article
- Article
- Efficiency of the Cerebroplacental Ratio in Identifying High-Risk Late-Term Pregnancies.Medicina (Kaunas, Lithuania) · 2023Article
- Diagnostic Tests in the Prediction of Neonatal Outcome in Early Placental Fetal Growth Restriction.Medicina (Kaunas, Lithuania) · 2023Article
- Fetal growth restriction and stillbirth: Biomarkers for identifying at risk fetuses.Frontiers in physiology · 2022Review
- An integrated approach based on advanced CTG parameters and Doppler measurements for late growth restriction management.BMC pregnancy and childbirth · 2021Observational
- Fetal cerebral blood-flow redistribution: analysis of Doppler reference charts and association of different thresholds with adverse perinatal outcome.Ultrasound in obstetrics & gynecology : the official journal of the International Society of Ultrasound in Obstetrics and Gynecology · 2021Observational
- The CErebro Placental RAtio as indicator for delivery following perception of reduced fetal movements, protocol for an international cluster randomised clinical trial; the CEPRA study.BMC pregnancy and childbirth · 2021Article
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Authors and funding
11 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveTo investigate if cerebroplacental ratio (CPR) adds to the predictive value of umbilical artery pulsatility index (UA PI) alone - standard of practice - for adverse perinatal outcome in singleton pregnancies. DESIGN AND
settingMeta-analysis based on individual participant data (IPD). POPULATION OR SAMPLE: Ten centres provided 17 data sets for 21 661 participants, 18 731 of which could be included. Sample sizes per data set ranged from 207 to 9215 individuals. Patient populations varied from uncomplicated to complicated pregnancies.
methodsIn a collaborative, pooled analysis, we compared the prognostic value of combining CPR with UA PI, versus UA PI only and CPR only, with a one-stage IPD approach. After multiple imputation of missing values, we used multilevel multivariable logistic regression to develop prediction models. We evaluated the classification performance of all models with receiver operating characteristics analysis. We performed subgroup analyses according to gestational age, birthweight centile and estimated fetal weight centile.
main outcome measuresComposite adverse perinatal outcome, defined as perinatal death, caesarean section for fetal distress or neonatal unit admission.
resultsAdverse outcomes occurred in 3423 (18%) participants. The model with UA PI alone resulted in an area under the curve (AUC) of 0.775 (95% CI 0.709-0.828) and with CPR alone in an AUC of 0.778 (95% CI 0.715-0.831). Addition of CPR to the UA PI model resulted in an increase in the AUC of 0.003 points (0.778, 95% CI 0.714-0.831). These results were consistent across all subgroups.
conclusionsCerebroplacental ratio added no predictive value for adverse perinatal outcome beyond UA PI, when assessing singleton pregnancies, irrespective of gestational age or fetal size. TWEETABLE ABSTRACT: Doppler measurement of cerebroplacental ratio in clinical practice has limited added predictive value to umbilical artery alone.
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