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

•Tobacco not associated independently with elevated Doppler measurements, or adverse outcome.•Doppler artery indices identified significant associations: IUGR, preeclampsia, low birth weight, pre-term birth and composite adverse outcome variable.•Umbilical and uterine left systolic/diastolic velocity ratios and nulliparity increased odds for adverse outcome.

ObjectiveThe purpose of this study was to investigate associations between Doppler measurements and adverse outcomes in an obstetric population with high tobacco use.MethodsThis retrospective study included patients with Doppler data (umbilical systolic/diastolic velocity ratios (S/D), uterine S/D, 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.Results338 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.ConclusionUmbilical and uterine left S/D indices and nulliparity are significant independent predictors of adverse outcomes.