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CME Credit Offered
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Abstract Award
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Poster Session 1

(323) Nuchal Translucency as a Predictor of Fetal Growth Restriction in the Absence of Genetic Abnormalities

Thursday, January 30, 2025
10:30 AM – 12:30 PM  

    Submitting Author and Presenting Author(s)

  • Rachel P. Gerber, MD

    Fellow, Maternal Fetal Medicine
    Northwell
    New Hyde Park, New York, United States

    • Coauthor(s)

  • Lizelle Comfort, MD (she/her/hers)

    Fellow, Maternal Fetal Medicine
    Northwell
    New Hyde Park, NY, United States

  • Frank I. Jackson, DO (he/him/his)

    Maternal Fetal Medicine Fellow
    Northwell
    New Hyde Park, New York, United States

  • RT

    Riley Thompson, BS

    Medical Student
    Zucker School of Medicine at Hofstra/Northwell
    New Hyde Park, New York, United States

  • RM

    Rajeevi Madankumar, MD

    Director, Prenatal Genetics
    Northwell
    New Hyde Park, New York, United States

  • Matthew J. Blitz, MD

    Director of Clinical Research, Maternal-Fetal Medicine, Northwell; Program Director, Maternal Fetal Medicine Fellowship, South Shore University Hospital
    Northwell
    Bay Shore, NY, United States

Objective:

To evaluate association between first trimester nuchal translucency (NT) and fetal growth restriction (FGR) in fetuses without suspected aneuploidy or structural anomaly.  



 


Study Design:

Singleton gestations with NT of at least 2mm with available third trimester fetal growth scan were included. Multifetal gestations, gestations with abnormal genetic screening, and fetuses with identified genetic or structural anomaly were excluded. Primary outcomes were diagnosis of FGR, as defined by abdominal circumference or estimated fetal weight less than 10th percentile, and severe FGR, as defined by abdominal circumference or estimated fetal weight less than 3rd percentile. NT values were stratified by measurements: 2-2.5mm, 2.5-3mm, and > 3mm and were controlled for crown rump length (CRL) at the time of nuchal translucency measurement. Linear regression was used to analyze first trimester NT and third trimester fetal growth.


Results:

5394 patients met inclusion criteria. Of these, 83.7% had a NT of 2-2.5mm, 10.3% 2.5-3mm, and 6% > 3mm. Compared to fetuses with a normal NT (2-2.5mm), those with borderline (2.5-3mm) and elevated ( >3mm) NT did not have a significantly higher incidence of FGR, though an association was seen. When adjusting for CRL, there was also no significant increased likelihood of FGR with an NT at the 95th percentile or higher (OR 1.06, 0.64-1.67). When evaluating severe FGR, there is an association between borderline NT (2.5-3mm) (OR 2.03, 0.75-4.69) and elevated NT ( >3mm) (OR 4.77, 1.99-10.26) with a higher incidence of severe FGR. There is also a significant association when adjusting for CRL: NT measurement at the 95th percentile or higher was strongly associated with severe FGR (OR 3.29, 1.58-6.49).


Conclusion: Elevated nuchal translucency is associated with third trimester severe FGR, in the absence of known aneuploidy or structural fetal anomaly. This association is seen both at borderline NT measurements (greater than 2.5mm) and when adjusting for CRL with NT measurements at the 95th percentile or higher.