ArticleUltrasound in obstetrics & gynecology : the official journal of the International Society of Ultrasound in Obstetrics and Gynecology2025
Routine 36-week scan: prediction of prolonged neonatal intensive care unit admission.
Article in Ultrasound in obstetrics & gynecology : the official journal of the International Society of Ultrasound in Obstetrics and Gynecology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
objectivesTo examine the contribution of maternal demographic characteristics and elements of medical history to the prediction of prolonged (> 2 days) neonatal intensive care unit (NICU) admission for high-dependency or intensive care, and to investigate the added value to such prediction of the findings from the 36-week ultrasound scan and data from labor and delivery.
methodsWe included 107 762 women with a singleton pregnancy who had undergone a routine ultrasound examination at 35 + 0 to 36 + 6 weeks' gestation. Assessment included medical history, estimated fetal weight (EFW), and Doppler measurements of uterine artery (UtA) pulsatility index (PI), umbilical artery (UA) PI and fetal middle cerebral artery (MCA) PI. Multivariable logistic regression was used to evaluate the independent contributions to prolonged NICU admission of maternal factors (demographic and pregnancy characteristics), findings from the 36-week scan, and data from labor and delivery. Detection rates (DRs) and areas under the receiver-operating-characteristics curve (AUCs) for prolonged NICU admission were compared.
resultsOverall, 946 (0.88%) neonates required prolonged NICU admission. The maternal factors that significantly contributed to prediction of prolonged NICU admission were body mass index, social deprivation, conception via in-vitro fertilization, chronic hypertension, Type-1 diabetes mellitus, pre-eclampsia and gestational diabetes mellitus. Screening by maternal factors provided a DR of 20.7% at a false-positive rate (FPR) of 10% (AUC, 0.606 (95% CI, 0.587-0.625)). Significant predictors from the 36-week scan included deepest vertical pocket of amniotic fluid < 2 cm and ≥ 8 cm, UA-PI >95
conclusionsMaternal factors (particularly social deprivation), 36-week scan findings, and data from labor and delivery each make an independent contribution to the risk of prolonged NICU admission at term. Nevertheless, more than 40% of these admissions are not predictable prior to labor and birth. © 2025 The Author(s). Ultrasound in Obstetrics & Gynecology published by John Wiley & Sons Ltd on behalf of International Society of Ultrasound in Obstetrics and Gynecology.
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