Perinatal outcomes of growth -restricted fetus with abnormal umbilical artery doppler waveform; a global systematic review and meta-analysis.
4 affiliations
- 1Department of Midwifery, College of Medicine & Health Sciences, Dilla University, Dilla, Ethiopia. [email protected].
- 2Department of midwifery, collage of health science, woldia university, Woldia, Ethiopia.
- 3Department of Midwifery, College of Medicine & Health Sciences, Dilla University, Dilla, Ethiopia.
- 4Department of Anesthesiology, College of Medicine & Health Sciences, Dilla University, Dilla, Ethiopia.
Abstract
Introduction
Intrauterine growth restriction (IUGR) is associated with increased perinatal risks, including stillbirth, NICU admission, and neonatal complications. Doppler ultrasound helps diagnose abnormal fetal circulation in high-risk pregnancies, distinguishing IUGR from simple small-for-gestational-age fetuses. This systematic review and meta-analysis aim to assess the perinatal outcomes of IUGR with abnormal umbilical artery Doppler findings, providing valuable insights for improving risk management and healthcare practices.Method
A systematic review and meta-analysis were conducted in adherence to the PRISMA guidelines. Comprehensive literature searches were performed across several global databases, including PubMed, Google Scholar, ScienceDirect, Web of Science, Scopus, and African Online Journal databases. The pooled estimates were calculated using a weighted inverse variance random-effects model. To assess heterogeneity among the included studies, the Cochrane Q-test and I² statistics were utilized. Publication bias was examined using a funnel plot and Egger's test. All statistical analyses were performed using Stata version 17 software.Result
A total of 1,003 articles were initially identified, from which 36 studies met the inclusion criteria and were included in the final meta-analysis. Overall, data from 8,624 women were analyzed. The pooled perinatal mortality rate among fetuses with intrauterine growth restriction (IUGR) and abnormal umbilical artery Doppler findings was 16.54% (95% CI: 12.93-20.15). The pooled NICU admission rate among these neonates was 69.37% (95% CI: 58.52-80.21), indicating a substantial burden on neonatal care services. Furthermore, the pooled prevalence of reversed end-diastolic flow (REDF) in the umbilical artery among IUGR fetuses was 22.03% (95% CI: 13.44-30.62). Subgroup analysis revealed that the highest pooled estimates of perinatal mortality were observed in Europe and Asia, whereas the lowest rates were reported in Australia. In terms of REDF prevalence, the highest estimates were found in studies conducted in North America.Conclusion
This meta-analysis identified perinatal death, NICU admission, and low APGAR score as the most common adverse outcomes associated with IUGR and abnormal Doppler findings. The pooled perinatal mortality rate was 16.54%, which is notably high compared to other causes of perinatal mortality.
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BibTeX
@article{gashaw2026perinatal,
title = {{Perinatal outcomes of growth -restricted fetus with abnormal umbilical artery doppler waveform; a global systematic review and meta-analysis.}},
author = {Anteneh Gashaw and Mulat Ayele and Yonas Abebe and Muluken Demeke and Belete Destaw and Addisu Getnet and Yayeh Adamu},
journal = {BMC pregnancy and childbirth},
year = {2026},
month = jul,
doi = {10.1186/s12884-026-09534-y},
url = {https://europepmc.org/article/MED/42928178},
note = {CC BY},
}
RIS
TY - JOUR
TI - Perinatal outcomes of growth -restricted fetus with abnormal umbilical artery doppler waveform; a global systematic review and meta-analysis.
AU - Anteneh Gashaw
AU - Mulat Ayele
AU - Yonas Abebe
AU - Muluken Demeke
AU - Belete Destaw
AU - Addisu Getnet
AU - Yayeh Adamu
PY - 2026
DA - 2026/07/28
JO - BMC pregnancy and childbirth
DO - 10.1186/s12884-026-09534-y
UR - https://europepmc.org/article/MED/42928178
AB - Introduction Intrauterine growth restriction (IUGR) is associated with increased perinatal risks, including stillbirth, NICU admission, and neonatal complications. Doppler ultrasound helps diagnose abnormal fetal circulation in high-risk pregnancies, distinguishing IUGR from simple small-for-gestational-age fetuses. This systematic review and meta-analysis aim to assess the perinatal outcomes of IUGR with abnormal umbilical artery Doppler findings, providing valuable insights for improving risk management and healthcare practices.Method A systematic review and meta-analysis were conducted in adherence to the PRISMA guidelines. Comprehensive literature searches were performed across several global databases, including PubMed, Google Scholar, ScienceDirect, Web of Science, Scopus, and African Online Journal databases. The pooled estimates were calculated using a weighted inverse variance random-effects model. To assess heterogeneity among the included studies, the Cochrane Q-test and I² statistics were utilized. Publication bias was examined using a funnel plot and Egger's test. All statistical analyses were performed using Stata version 17 software.Result A total of 1,003 articles were initially identified, from which 36 studies met the inclusion criteria and were included in the final meta-analysis. Overall, data from 8,624 women were analyzed. The pooled perinatal mortality rate among fetuses with intrauterine growth restriction (IUGR) and abnormal umbilical artery Doppler findings was 16.54% (95% CI: 12.93-20.15). The pooled NICU admission rate among these neonates was 69.37% (95% CI: 58.52-80.21), indicating a substantial burden on neonatal care services. Furthermore, the pooled prevalence of reversed end-diastolic flow (REDF) in the umbilical artery among IUGR fetuses was 22.03% (95% CI: 13.44-30.62). Subgroup analysis revealed that the highest pooled estimates of perinatal mortality were observed in Europe and Asia, whereas the lowest rates were reported in Australia. In terms of REDF prevalence, the highest estimates were found in studies conducted in North America.Conclusion This meta-analysis identified perinatal death, NICU admission, and low APGAR score as the most common adverse outcomes associated with IUGR and abnormal Doppler findings. The pooled perinatal mortality rate was 16.54%, which is notably high compared to other causes of perinatal mortality.
SN - 1471-2393
ER -