Care-Related and Maternal Risk Factors Associated with the Antenatal Nondetection of Intrauterine Growth Restriction: A Case-Control Study from Bremen, Germany

Abstract

Objective. To identify care-related and maternal risk factors for the antenatal nondetection of IUGR. Methods. In this hospital-based case-control study we compared antenatally undetected IUGR neonates (cases) to detected IUGR neonates (controls). Data were collected using newborn documentation sheets and standardized personal interviews with the mothers. We calculated antenatal detection rates and used uni- and multivariable logistic regression models to assess the association of antenatal nondetection of IUGR and maternal and care-related factors. Results. A total of 161 neonates from three hospitals were included in the study. Suboptimal fetal growth was identified antenatally in n = 77 pregnancies while in n = 84 it was not detected antenatally (antenatal detection rate: 47.8%). Severity of IUGR, maternal complications, and a Doppler examination during the course of pregnancy were associated with IUGR detection. We did not find statistically significant differences regarding parental socioeconomic status and maternal migration background. Conclusions. In our study, about half of all pregnancies affected by suboptimal growth remained undetected. Future in-depth studies with larger study populations should further examine factors that could increase antenatal detection rates for IUGR.

Adequação do peso ao nascer para idade gestacional de acordo com a curva INTERGROWTH-21 st e fatores associados ao pequeno para idade gestacional

“…Vale ressaltar que não consta das diretrizes do pré-natal no Brasil 19 o monitoramento via ultrassonografia para o crescimento intrauterino, conforme recomendado em outros países, como França e Canadá 32,33 . O acréscimo desse procedimento pode ampliar a detecção do CIR e tornar mais eficaz o pré-natal no controle desse desfecho.…”

Maternal and fetal factors associated with non detection of fetal growth restriction at term: a retrospective study

“…This rate of detection is more than seen in other studies where the detection rate was about 50%. 5 Chances of not missing FGR cases was more in neonates with birth weight of <2 kg as seen in the study by Alexandra et al 13 This can be picked up by diligent obstetric examination and third trimester ultrasound and fetal Doppler studies if indicated. The present study also confirms that most of the cases of FGR missed if the birth weight is between 2-2.5 kg as 95% of non-detected FGR cases were falling in this group.…”

Alteration in 11 Beta-Hydroxysteroid Dehydrogenase Type-2 (HSD11B2) Gene as A Potential Candidate Parameter for Early Detection of Intrauterine Growth Restriction (IUGR) Events

“…6 The detection of IUGR cases had not improved since the late 1990s, and about half of the pregnancies with IUGR were undetected. 7 Also, ultrasonography is also very operator-dependent, so that the interpretation of the results may differ. 8 To examine IUGR, a safe alternative method, called non-invasive prenatal testing (NIPT) or somewhile called non-invasive prenatal screening (NIPS), can be conducted.…”