TOPLINE:

Middle cerebral artery (MCA) Doppler and cerebroplacental ratio (CPR) independently predicted composite adverse neurologic outcomes in foetuses with foetal growth restriction (FGR).

METHODOLOGY:

• Researchers conducted a retrospective cohort study to evaluate whether MCA Doppler ultrasonography could effectively predict adverse neurologic outcomes in foetuses with FGR.
• They included 83 singleton pregnancies (average maternal age, 33.49 years) with a prenatal diagnosis of FGR at an obstetrics and gynaecology clinic in Italy between 2018 and 2019.
• Clinical charts were reviewed to analyse MCA Doppler indices (MCA pulsatility index [PI] z-score and CPR z-score) alongside neurologic and respiratory outcomes.

TAKEAWAY:

• After adjustment for gestational age and birth weight z‐score, the MCA PI z-score (adjusted odds ratio [aOR], 0.59) and CPR z-score (aOR, 0.67; P < .05 for both) were independent predictors of composite adverse neurologic outcomes.
• A multivariable model incorporating CPR z-score, gestational age, and birth weight z-score improved the prediction of adverse neurologic outcomes, achieving an area under the receiver operating characteristic curve of 80.30%.
• Doppler measures did not predict adverse neonatal respiratory outcomes and showed no association with neonatal head circumference.

IN PRACTICE:

"Policymakers and healthcare providers should take these findings into account when developing guidelines for managing high‐risk pregnancies and investing in Doppler ultrasound training and resources to improve prenatal care quality," the authors wrote.

SOURCE:

This study was led by Silvia Visentin, Padova Hospital and Department of Women's and Children's Health, School of Medicine, Padova Hospital and University, Padova, Italy. It was published online on May 28, 2026, in Prenatal Diagnosis.

LIMITATIONS:

The retrospective design and the use of data from clinical charts may have introduced biases due to insufficient or inconsistent data collection. The exclusion of cases without ultrasound data within 1 week of delivery may have limited the generalisability of the findings. The small sample size may have restricted statistical power and precision, especially in subgroup analyses.

DISCLOSURES:

No funding sources were reported for this study. The authors declared having no conflicts of interest.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.