Normative references and clinical correlates of fetal umbilical artery Doppler indices in southwestern Nigeria.

Abstract

To derive normative references for umbilical artery (UA) Doppler indices, including pulsatility index (PI), resistance index (RI), and systolic/diastolic (SD) ratio, for singleton pregnancies in Ile-Ife, Nigeria, and compare them with reference values from other populations. A longitudinal study involving 415 women with a singleton fetus at 26-40 gestational weeks attending Obafemi Awolowo University Hospital, Ile-Ife, between July 2015 and March 2019. Fetal UA PI, RI, and SD ratio were measured every 4weeks until delivery. Reference values from the 2.5th to the 97.5th centiles were derived from 1375 measurements. Correlations between indices and bio-demographic characteristics were assessed; regression equations were generated. The RI, PI, and SD ratio decreased by 0.013, 0.027, and 0.71, respectively, for each additional week of pregnancy. There was a negative correlation between the three indices and birthweight (P<0.001), but not maternal parity, age, or fetal gender. Regression equations for RI, PI, and SD ratio were, respectively, 1.004-0.013x, 1.78-0.027x, and 4.77-0.71x, where x is gestational age (weeks). The derived normative references for fetal UA Doppler indices are recommended for monitoring high-risk pregnancies in Nigeria. The indices are comparable to those derived from Norwegian, Thai, and British cohorts.