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DOI: 10.1055/a-1787-7744
Comment: The Effect of Antenatal Vaginal Progesterone Administration on Uterine, Umbilical, and Fetal Middle Cerebral Artery Doppler Flow: A Cohort Study
We note some implausible features of the data reported in article by Maged et al published in April 2020.[1]
The authors recruited pregnant women with a gestational age from 18 to 34 weeks with a singleton living normal fetus, and a mean gestational age at recruitment of 31.43 weeks. The mean estimated fetal weight (EFW) at the same time point was 2,481 g. In our [Fig. 1] we have plotted this EFW on the Intergrowth chart.[2] It is nearly 1 kg higher than would be expected, and not a plausible mean value for normal fetuses at this gestational age.
The authors recruited women at risk of preterm birth because of “a history of prior PTB and/or short cervical length <25 mm in the current pregnancy.” Since 43% of the participants had a history of preterm birth (Maged Table 1) at least 57% of participants had a cervix <25 mm. Since the overall mean cervical length was 33.9 mm (standard deviation [SD]: 0.53) (Maged Table 1), the mean cervical length of the women with a previous preterm birth must be at least 46 mm. This calculation assumes that the short cervix group all had a cervical length of exactly 25 mm and that none of the previous preterm group also had a short cervix. If in practice some short cervix participants had a cervical length below 25 mm and there was overlap between the groups, the mean cervical length for the isolated preterm labor group would be even higher. A cervical length of 46 mm would lie on the 90th centile for normal pregnancy according to Salomon et al[3] and seems an unlikely mean value for women with a history of preterm birth.
Neonatal intensive care unit admission was reported to occur in 7.5% of the pregnancies (Maged Table 1); 7.5% of 80 equals six babies. It is unclear how in six babies 70% can have transient tachypnea of the newborn, 10% respiratory distress syndrome, and 20% jaundice (Maged Table 1).
The abstract and methods state that the sonographic measures were made 1 week after the progesterone administration. However, in Maged [Fig. 1] it is stated that the interval was 48 hours.
We recalculated the p-values for Maged Table 2 (see our [Fig. 2]). These seem to be incorrect.
Can we suggest that you ask to see the original data for this study?
Sincerely
Publikationsverlauf
Eingereicht: 03. November 2021
Angenommen: 18. Februar 2022
Accepted Manuscript online:
03. März 2022
Artikel online veröffentlicht:
06. Mai 2022
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References
- 1 Maged AM, Shoab AY, Hussein EA. et al. The effect of antenatal vaginal progesterone administration on uterine, umbilical, and fetal middle cerebral artery doppler flow: a cohort study. Am J Perinatol 2020; 37 (05) 491-496
- 2 Stirnemann J, Villar J, Salomon LJ. et al; International Fetal and Newborn Growth Consortium for the 21st Century (INTERGROWTH-21st), Scientific Advisory Committee, Steering Committees, INTERGROWTH-21st, INTERBIO-21st, Executive Committee, In addition for INTERBIO 21st, Project Coordinating Unit, Data Analysis Group, Data Management Group, In addition for INTERBIO 21st, Ultrasound Group, In addition for INTERBIO-21st, Anthropometry Group, In addition for INTERBIO-21st, Laboratory Processing Group, Neonatal Group, Environmental Health Group, Neurodevelopment Group, Participating countries and local investigators, In addition for INTERBIO-21st, In addition for INTERBIO-21st. International estimated fetal weight standards of the INTERGROWTH-21st project. Ultrasound Obstet Gynecol 2017; 49 (04) 478-486
- 3 Salomon LJ, Diaz-Garcia C, Bernard JP, Ville Y. Reference range for cervical length throughout pregnancy: non-parametric LMS-based model applied to a large sample. Ultrasound Obstet Gynecol 2009; 33 (04) 459-464