The Welsh study of mothers and babies: protocol for a population-based cohort study to investigate the clinical significance of defined ultrasound findings of uncertain significance

BMC Pregnancy and Childbirth

Shantini Paranjothy⁷  Colin Davies⁵  Lyn Chitty¹  Marilyn Ann Wills⁶  David Tucker⁷  Sue Morris⁸  Gareth John²  David Fone⁷  Frank Dunstan⁴  Susan Thomas⁷  Fiona Brook³  Melissa Wright⁴  Lisa Hurt⁴ 

[1] UCL Institute of Child Health, London WC1N 1EH and Great Ormond Street and UCLH NHS Foundation Trusts London, 30 Guilford St, London, UK;NHS Wales Informatics Service, 12th Floor, Brunel House, 2 Fitzalan Road, Cardiff CF24 0HA, UK;Aneurin Bevan University Health Board, Lodge Road, Caerleon, Newport NP18 3XQ, UK;Institute of Primary Care and Public Health, School of Medicine, Cardiff University, Neuadd Meirionnydd, Heath Park, Cardiff CF14 4YS, UK;Cwm Taf University Health Board, Ynysmeurig House, Navigation Park, Abercynon, Rhondda Cynon Taff CF45 4SN, UK;National Childbirth Trust, Alexandra House, Oldham Terrace, London W3 6NH, UK;Public Health Wales NHS Trust, 14 Cathedral Road, Cardiff CF11 9LJ, UK;Cardiff and Vale University Health Board, Cardigan House, University Hospital of Wales, Heath Park, Cardiff CF14 4XW, UK

关键词: Small for gestational age;    Pre-term birth;    Stillbirths;    Congenital abnormality;    Short femur;    Choroid plexus cysts;    Cardiac echogenic foci;    Nuchal thickening;    Renal pelvicalyceal dilatation;    Cerebral ventriculomegaly;    Echogenic bowel;    Markers;    Anomaly;    Ultrasound;   

Others  :  1127343
DOI  :  10.1186/1471-2393-14-164

 received in 2014-04-09, accepted in 2014-04-24,  发布年份 2014

【 摘 要 】

Background

Improvement in ultrasound imaging has led to the identification of subtle non-structural markers during the 18 – 20 week fetal anomaly scan, such as echogenic bowel, mild cerebral ventriculomegaly, renal pelvicalyceal dilatation, and nuchal thickening. These markers are estimated to occur in between 0.6% and 4.3% of pregnancies. Their clinical significance, for pregnancy outcomes or childhood morbidity, is largely unknown. The aim of this study is to estimate the prevalence of seven markers in the general obstetric population and establish a cohort of children for longer terms follow-up to assess the clinical significance of these markers.

Methods/Design

All women receiving antenatal care within six of seven Welsh Health Boards who had an 18 to 20 week ultrasound scan in Welsh NHS Trusts between July 2008 and March 2011 were eligible for inclusion. Data were collected on seven markers (echogenic bowel, cerebral ventriculomegaly, renal pelvicalyceal dilatation, nuchal thickening, cardiac echogenic foci, choroid plexus cysts, and short femur) at the time of 18 – 20 week fetal anomaly scan. Ultrasound records were linked to routinely collected data on pregnancy outcomes (work completed during 2012 and 2013). Images were stored and reviewed by an expert panel.

The prevalence of each marker (reported and validated) will be estimated. A projected sample size of 23,000 will allow the prevalence of each marker to be estimated with the following precision: a marker with 0.50% prevalence to within 0.10%; a marker with 1.00% prevalence to within 0.13%; and a marker with 4.50% prevalence to within 0.27%. The relative risk of major congenital abnormalities, stillbirths, pre-term birth and small for gestational age, given the presence of a validated marker, will be reported.

Discussion

This is a large, prospective study designed to estimate the prevalence of markers in a population-based cohort of pregnant women and to investigate associations with adverse pregnancy outcomes. The study will also establish a cohort of children that can be followed-up to explore associations between specific markers and longer-term health and social outcomes.

【 授权许可】

   
2014 Hurt et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

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