Perinatal Outcomes in Persistent Fetal Growth Restriction and Growth Restriction Based Upon Growth Velocity [34S]

Abstract

INTRODUCTION: Fetal growth restriction (FGR) is associated with adverse perinatal outcomes. The aim of our study was to assess NICU admission rates and composite neonatal morbidity (CNM) in pregnancies with persistent FGR, and to evaluate fetal outcomes based on FGR associated with negative growth velocity. METHODS: We conducted a retrospective cohort study of women with non-anomalous singleton pregnancies complicated by FGR who delivered at our institution. Growth velocity was calculated by subtracting the EFW percentile at the final growth scan from the percentile at the first growth scan and dividing by the number of weeks between the scans. RESULTS: 124 women with pregnancies complicated by FGR were identified. 82 women met inclusion criteria for growth velocity evaluation, 91 women met criteria for assessment of perinatal outcomes of interest. Patients with persistent FGR had an earlier gestational age at time of delivery (36.2 vs. 37.7 wks, p= 0.01), and lower birth weight (2150 gm vs 2601 gm, p=0.005). NICU admission and CNM were higher in pregnancies with persistent FGR (40.3% vs. 13.6%, p=0.036, 37.7% vs. 13.6, p=0.039). Neonates with negative growth velocity more likely delivered at an earlier gestational age (36.2 vs 37.6 weeks, p=0.027), delivered by cesarean section (59.1% vs 36.8%, p=0.044) and had lower birthweight (2154 vs 2475 grams, p=0.020). CONCLUSION: Pregnancies with persistent FGR are associated with increased NICU admissions, and composite neonatal morbidity. Similarly, pregnancies with FGR and negative growth velocity are more likely to deliver early, have lower birthweight, and deliver by cesarean section compared to those with growth.