Correlation of Modified Biophysical Profile in High-Risk Pregnancy and Its Fetal Outcome

Abstract

Background: High-risk pregnancies, including those complicated by preeclampsia, gestational diabetes, oligohydramnios, or post-dated gestation, are associated
with increased perinatal morbidity and mortality. Early identification of fetuses at risk of hypoxia is essential for timely intervention. The Modified Biophysical
Profile (MBPP), combining the non-stress test (NST) and amniotic fluid index (AFI), offers a simplified, time-efficient alternative to the conventional biophysical
profile (BPP) for fetal surveillance.
Objective: To evaluate the correlation between MBPP findings and perinatal outcomes in high-risk pregnancies and to assess its diagnostic accuracy in comparison
with NST and AFI using ROC curve analysis.
Methods: A prospective, observational study was conducted on 125 high-risk antenatal women (>32 weeks of gestation). Participants underwent MBPP assessment,
categorizing results as normal (reactive NST + AFI >5 cm) or abnormal (non-reactive NST and/or AFI <5 cm). Fetal outcomes, including mode of delivery, liquor
status, Apgar scores, birth weight, gestational age at delivery, and NICU admission, were documented. Data were analysed using Chi-square tests, and the diagnostic
performance of MBPP, NST, and AFI was evaluated using Receiver Operating Characteristic (ROC) curves.
Results: Among 125 participants, 40% had abnormal MBPP. Abnormal MBPP was significantly associated with increased cesarean deliveries (p=0.002), abnormal
1- and 5-minute Apgar scores (64% vs. 22.7% and 40% vs. 8%, respectively; p<0.001), low birth weight (50% vs. 25.3%, p=0.005), preterm birth (22% vs. 8%,
p=0.045), and higher NICU admissions (54% vs. 12%, p<0.001). ROC curve analysis demonstrated that MBPP had superior diagnostic accuracy (AUC = 0.800)
compared to NST (AUC = 0.670) and AFI (AUC = 0.678), with all parameters showing statistical significance (p ≤ 0.001).
Conclusion: Abnormal MBPP is strongly associated with adverse perinatal outcomes. ROC analysis further confirms that MBPP has better predictive performance
than NST or AFI alone, supporting its role as an effective, rapid, and reliable tool for fetal surveillance in high-risk pregnancies, particularly in resource-limited
settings.