Perinatal and Neonatal Outcomes in Fetal Growth Restriction and Small for Gestational Age

Abstract

Alterations in intrauterine fetal growth increase the risk of adverse perinatal and neonatal outcomes. In this retrospective study, we analyzed data of 906 pregnancies collected in our maternal fetal medicine center, with different patterns of growth: 655 AGA (Appropriate for Gestational Age), 62 SGA (Small for Gestational Age: fetuses born with a weight less than 10° centile, not diagnosed before delivery), 189 FGR (Fetal Growth Restriction, classified in early and late according to gestational week at diagnosis). For each group, we compared maternal characteristics, gestational age at delivery, and perinatal and neonatal outcomes. Risk factors for fetal growth alterations were advanced age, being primiparous, and a lower pregestational BMI. FGR fetuses were born at earlier gestational ages (32 [IQR 29–38] early-FGR and 38 [IQR 36–39] late-FGR), with blood gas values comparable to the AGA group but worse neonatal outcomes related to prematurity. Unexpected SGA fetuses born by vaginal delivery, managed as AGA, were more hyperlactacidemic (4.4 [IQR 2.7–5.5]) and hypoxemic (−5.0 [IQR −7.1–2.8]) at birth than both AGA and FGR. However, neonatal outcomes (accesses and days of hospitalization in NICU) were better than FGR, likely due to gestational age and birthweight similar to AGA.

Insights into Prevention of Health Complications in Small for Gestational Age (SGA) Births in Relation to Maternal Characteristics: A Narrative Review

“…Malnutrition during pregnancy and low pre-pregnancy BMI have significant negative effects on birthweight [ 57 , 58 , 59 ]. Given that approximately 829 million people worldwide are exposed to hunger, this global problem may also have a deleterious effect on pregnant women in some regions and populations.…”

Mirroring Perinatal Outcomes in a Romanian Adolescent Cohort of Pregnant Women from 2015 to 2021

“…Fetus according to gestational age (AGA)—fetuses with a birthweight between the 10th and 90th percentile for the gestational age [ 26 ].…”

“…-Fetus according to gestational age (AGA)-fetuses with a birthweight between the 10th and 90th percentile for the gestational age [26]. -Small for gestational age (SGA)-fetuses with birthweight less than the 10th percentile for the gestational age, but higher than the 3rd percentile, in accordance with their genetic growth potential [27].…”

Perbandingan Faktor Risiko antara Pertumbuhan Janin Terhambat Onset Dini dan Lambat di RSUD Dr. Moewardi

“…Pada ibu usia muda terdapat kompetisi antara ibu dan janin dalam memperebutkan nutrisi disebabkan belum sempurnanya maturasi fisik ibu. [7][8] Usia ibu >30 tahun menjadi faktor risiko pada PJT onset dini. 8 Untuk ibu di atas 30 tahun, gangguan kesehatan pada ibu seperti hipertensi dan diabetes dapat meningkatkan risiko.…”

“…Hal ini sesuai dengan penelitian yang dilakukan oleh Inácio et al 5 Hasil yang berbeda terdapat pada penelitian Lubrano et al yang melaporkan terdapat perbedaan yang bermakna IMT antara pertumbuhan janin terhambat onset dini dan lambat. 7 Pada penelitian Kozuki et al menyatakan ibu dengan IMT <18,5 cenderung terdiagnosis onset dini. 4 Ibu dengan kategori IMT underweight mengalami ketidakcukupan nutrisi yang didapatkan janin selama masa kehamilan dan berimbas pada janin yang memiliki berat lebih kecil dibanding usia kehamilannya.…”