OP15.07: Association between the cerebroplacental ratio and fetal growth disorders in monochorionic twins
Bibliographic record
Abstract
To determine whether a low cerebroplacental ratio (CPR) is associated with fetal growth disorders in monochorionic twins. This was a retrospective cohort study of 164 pathologically confirmed monochorionic twin gestations, delivering after 20 weeks at The Ottawa Hospital, between January 2014 and December 2017. Primary outcomes included presence of IUGR in one or both twins (EFW<10%), growth discordance (>20%), and selective IUGR (IUGR+growth discordance). We investigated the relationship of these outcomes to low CPR<2.5%, elevated UA-PI>95%, low MCA-PI<5%, and inter-twin Doppler discordance. SAS 9.4 was used for statistical analyses. For categorical variables, differences between groups were calculated using Chi-square or Fisher exact tests. For continuous variables, differences in means or medians were calculated using t-test, Wilcoxon rank sum, ANOVA and Kruskal-Wallis tests. P <0.05 was considered statistically significant. Fetal growth disorders were present in 34.7% of monochorionic twin pregnancies: 16.4% were IUGR, 5.5% were growth discordant and 12.8% were sIUGR. Low CPR was significantly associated with growth disorders, comprising 38.5% of IUGR, 33.3% of growth discordance, 61.1% of sIUGR, versus 23.4% of normal growth(p=0.011). Growth disorders were also significantly associated with elevated UA-PI(p=0.001) and low MCA-PI(p=0.009). For inter-twin Doppler discordance, only UA-PI discordance was significant between groups, with median(IQR) of 13%(9-20%) for IUGR, 12%(8-18%) for growth discordance and 21%(14-28%) for sIUGR, versus 13%(8-16%) for normal growth (p<0.001). CPR and MCA-PI discordance were not significantly different in twins with growth disorders compared to those with normal growth. Low CPR, elevated UA-PI and low MCA-PI are significantly associated with fetal growth disorders in monochorionic twin pregnancies. Further study is needed to better establish these relationships, as well as those between other adverse obstetrical and neonatal outcomes and Doppler variables in this population. Please note: The publisher is not responsible for the content or functionality of any supporting information supplied by the authors. Any queries (other than missing content) should be directed to the corresponding author for the article.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.022 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".