Outcomes of pregnancies with varying levels of nuchal translucency measurements: A population‐based retrospective study in Ontario, Canada
Abstract Introduction Nuchal translucency prenatal ultrasound is widely used to screen for chromosomal abnormalities. An elevated nuchal translucency has been associated with adverse outcomes such as pregnancy loss; however, extant studies investigating these associations have had important limitati...
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Wiley
2024-12-01
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| Series: | Acta Obstetricia et Gynecologica Scandinavica |
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| Online Access: | https://doi.org/10.1111/aogs.14965 |
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| author | Kara Bellai‐Dussault Shelley D. Dougan Deshayne B. Fell Carolina Lavin Venegas Julian Little Lynn Meng Nan Okun Mark Walker Christine M. Armour Beth K. Potter |
| author_facet | Kara Bellai‐Dussault Shelley D. Dougan Deshayne B. Fell Carolina Lavin Venegas Julian Little Lynn Meng Nan Okun Mark Walker Christine M. Armour Beth K. Potter |
| author_sort | Kara Bellai‐Dussault |
| collection | DOAJ |
| description | Abstract Introduction Nuchal translucency prenatal ultrasound is widely used to screen for chromosomal abnormalities. An elevated nuchal translucency has been associated with adverse outcomes such as pregnancy loss; however, extant studies investigating these associations have had important limitations, including selection bias. This study aimed to investigate the association between nuchal translucency measurements and pregnancy outcome, specifically, a composite of pregnancy loss, termination, stillbirth, or neonatal death. Material and Methods This was a population‐based retrospective cohort study conducted with data from the prescribed perinatal registry in Ontario, Canada, Better Outcomes Registry & Network. All singleton pregnancies with an estimated date of delivery from September 1, 2016, to March 31, 2021, and multiple marker screening including a nuchal translucency were included. Pregnancies with measurements 2.0‐ < 2.5 mm, 2.5‐ < 3.0 mm, 3.0‐ < 3.5 mm, 3.5‐ < 5.0 mm, 5.0‐ < 6.5 mm, and ≥6.5 mm were compared to a reference group with measurements <2.0 mm. We used multivariable modified Poisson regression models with robust variance estimation to estimate associations between nuchal translucency measurement and pregnancy outcome, with adjustment for age at estimated date of delivery and gestational age at screening. Results There were 414 268 singleton pregnancies included in the study. The risk of pregnancy loss, termination, stillbirth, or neonatal death increased with increasing levels of nuchal translucency measurements, with an adjusted risk ratio (aRR) of 11.9 (95% confidence interval (CI) 9.9, 14.3) in the group with measurements 3.5‐ < 5.0 mm. When pregnancies with diagnosed chromosomal abnormalities were excluded, this association remained strong, with an aRR of 6.4 (95% CI 4.8, 8.5). Among pregnancies with a live birth, those with a higher nuchal translucency measurement (>5.0 mm vs. <2.0 mm) were also at increased risk of adverse perinatal outcomes such as admission to the neonatal intensive care unit and APGAR score <7. Conclusions In this population‐based study using robust methods to reduce the risk of selection bias, we found that pregnancies with increased nuchal translucency measurements are less likely to result in a live birth, even with the exclusion of chromosomal abnormalities. Pregnancies with increased nuchal translucency measurements that resulted in a live birth may also be at increased risk of adverse perinatal outcomes. |
| format | Article |
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| institution | OA Journals |
| issn | 0001-6349 1600-0412 |
| language | English |
| publishDate | 2024-12-01 |
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| spelling | doaj-art-09cb5dce5a544d0f9590023f8769c1be2025-08-20T02:09:24ZengWileyActa Obstetricia et Gynecologica Scandinavica0001-63491600-04122024-12-01103122499251010.1111/aogs.14965Outcomes of pregnancies with varying levels of nuchal translucency measurements: A population‐based retrospective study in Ontario, CanadaKara Bellai‐Dussault0Shelley D. Dougan1Deshayne B. Fell2Carolina Lavin Venegas3Julian Little4Lynn Meng5Nan Okun6Mark Walker7Christine M. Armour8Beth K. Potter9University of Ottawa, School of Epidemiology and Public Health Ottawa Ontario CanadaPrenatal Screening Ontario, Better Outcomes Registry & Network (BORN) Ontario Ottawa Ontario CanadaUniversity of Ottawa, School of Epidemiology and Public Health Ottawa Ontario CanadaPrenatal Screening Ontario, Better Outcomes Registry & Network (BORN) Ontario Ottawa Ontario CanadaUniversity of Ottawa, School of Epidemiology and Public Health Ottawa Ontario CanadaPrenatal Screening Ontario, Better Outcomes Registry & Network (BORN) Ontario Ottawa Ontario CanadaPrenatal Screening Ontario, Better Outcomes Registry & Network (BORN) Ontario Ottawa Ontario CanadaPrenatal Screening Ontario, Better Outcomes Registry & Network (BORN) Ontario Ottawa Ontario CanadaPrenatal Screening Ontario, Better Outcomes Registry & Network (BORN) Ontario Ottawa Ontario CanadaUniversity of Ottawa, School of Epidemiology and Public Health Ottawa Ontario CanadaAbstract Introduction Nuchal translucency prenatal ultrasound is widely used to screen for chromosomal abnormalities. An elevated nuchal translucency has been associated with adverse outcomes such as pregnancy loss; however, extant studies investigating these associations have had important limitations, including selection bias. This study aimed to investigate the association between nuchal translucency measurements and pregnancy outcome, specifically, a composite of pregnancy loss, termination, stillbirth, or neonatal death. Material and Methods This was a population‐based retrospective cohort study conducted with data from the prescribed perinatal registry in Ontario, Canada, Better Outcomes Registry & Network. All singleton pregnancies with an estimated date of delivery from September 1, 2016, to March 31, 2021, and multiple marker screening including a nuchal translucency were included. Pregnancies with measurements 2.0‐ < 2.5 mm, 2.5‐ < 3.0 mm, 3.0‐ < 3.5 mm, 3.5‐ < 5.0 mm, 5.0‐ < 6.5 mm, and ≥6.5 mm were compared to a reference group with measurements <2.0 mm. We used multivariable modified Poisson regression models with robust variance estimation to estimate associations between nuchal translucency measurement and pregnancy outcome, with adjustment for age at estimated date of delivery and gestational age at screening. Results There were 414 268 singleton pregnancies included in the study. The risk of pregnancy loss, termination, stillbirth, or neonatal death increased with increasing levels of nuchal translucency measurements, with an adjusted risk ratio (aRR) of 11.9 (95% confidence interval (CI) 9.9, 14.3) in the group with measurements 3.5‐ < 5.0 mm. When pregnancies with diagnosed chromosomal abnormalities were excluded, this association remained strong, with an aRR of 6.4 (95% CI 4.8, 8.5). Among pregnancies with a live birth, those with a higher nuchal translucency measurement (>5.0 mm vs. <2.0 mm) were also at increased risk of adverse perinatal outcomes such as admission to the neonatal intensive care unit and APGAR score <7. Conclusions In this population‐based study using robust methods to reduce the risk of selection bias, we found that pregnancies with increased nuchal translucency measurements are less likely to result in a live birth, even with the exclusion of chromosomal abnormalities. Pregnancies with increased nuchal translucency measurements that resulted in a live birth may also be at increased risk of adverse perinatal outcomes.https://doi.org/10.1111/aogs.14965chromosomal abnormalitiesnuchal translucencyperinatal outcomespregnancy outcomeprenatal screening |
| spellingShingle | Kara Bellai‐Dussault Shelley D. Dougan Deshayne B. Fell Carolina Lavin Venegas Julian Little Lynn Meng Nan Okun Mark Walker Christine M. Armour Beth K. Potter Outcomes of pregnancies with varying levels of nuchal translucency measurements: A population‐based retrospective study in Ontario, Canada Acta Obstetricia et Gynecologica Scandinavica chromosomal abnormalities nuchal translucency perinatal outcomes pregnancy outcome prenatal screening |
| title | Outcomes of pregnancies with varying levels of nuchal translucency measurements: A population‐based retrospective study in Ontario, Canada |
| title_full | Outcomes of pregnancies with varying levels of nuchal translucency measurements: A population‐based retrospective study in Ontario, Canada |
| title_fullStr | Outcomes of pregnancies with varying levels of nuchal translucency measurements: A population‐based retrospective study in Ontario, Canada |
| title_full_unstemmed | Outcomes of pregnancies with varying levels of nuchal translucency measurements: A population‐based retrospective study in Ontario, Canada |
| title_short | Outcomes of pregnancies with varying levels of nuchal translucency measurements: A population‐based retrospective study in Ontario, Canada |
| title_sort | outcomes of pregnancies with varying levels of nuchal translucency measurements a population based retrospective study in ontario canada |
| topic | chromosomal abnormalities nuchal translucency perinatal outcomes pregnancy outcome prenatal screening |
| url | https://doi.org/10.1111/aogs.14965 |
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