Doppler screening and predictors of adverse outcomes in high risk pregnancies affected by tobacco

Objective: The purpose of this study was to investigate associations between Doppler measurements and adverse outcomes in an obstetric population with high tobacco use. Methods: This retrospective study included patients with Doppler data (umbilical systolic/diastolic velocity ratios (S/D), uterine SID, uterine left/right ratio index (RI)). Receiver operator characteristic curve analysis determined cut-off elevated Doppler indices. Stepwise logistic regression was used to predict adverse outcomes. Results: 338 of 745 patients (45.4%) had adverse outcomes. Doppler artery indices identified significant associations with IUGR, preeclampsia, low birth weight, pre-term birth and composite adverse outcome variable. An elevated Umbilical S/D was 2.1 (95% Confidence Interval (CI): 1.5-2.9; p <0.001) times was more likely to have an adverse outcome. For left uterine artery S/D and nulliparity, the odds ratios were 1.8 (95% CI: 1.3-2.5) and 1.4 (95% CI: 1.0-1.9), respectively. Conclusion: Umbilical and uterine left S/D indices and nulliparity are significant independent predictors of adverse outcomes.(C) 2016 Elsevier Inc. All rights reserved.