Perinatal Outcomes of Fetuses with Early Growth Restriction, Late Growth Restriction, Small for Gestational Age, and Adequate for Gestational Age

Inácio, Quênya Antunes Silveira; Júnior, Edward Araujo; Nardozza, Luciano Marcondes Machado; Petrini, Caetano Galvão; Campos, Victor Paranaíba; Peixoto, Alberto Borges

doi:10.1055/s-0039-1697987

Cited by 8 publications

(7 citation statements)

References 27 publications

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“…The present study, comparable with previous studies, demonstrates that EO-and LO-FGR have completely different perinatal and obstetric outcomes with higher incidences of perinatal mortality, preeclampsia and Doppler abnormalities in EO-FGR pregnancies (3,15,16). Defective placentation reflected by abnormal UtA and UA Doppler velocimetry findings is the main cause of EO-FGR, in which pregnancy is not accepted to continue beyond 34 weeks with such improper placenta formation (4,17).…”

Section: Discussionsupporting

confidence: 86%

Perinatal Outcomes and Prognostic Factors in Early and Late-Onset Fetal Growth Restriction

Madazli¹,

Alpay²,

Kaymak³

et al. 2022

J Istanb Fac Med

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Objective: To evaluate the obstetric and perinatal outcomes of fetuses with early (EO) and late-onset (LO) fetal growth restriction (FGR), and to explore the prognostic factors on perinatal survival and adverse perinatal outcome. Materials and Methods:We retrospectively reviewed 105 EOand 55 LO-FGR singleton pregnancies. Umbilical artery (UA), middle cerebral artery (MCA) and ductus venosus (DV) Doppler parameters and cerebroplacental ratio (CPR) were assessed. Prognostic significance of gestational age at delivery, birth weight and Doppler parameters were evaluated.Results: Gestational age at delivery greater than 27 weeks (sensitivity 87.5%, specificity 76%) and birth weight of 665 g (sensitivity 88.8%, specificity 92%) provided the best prediction of survival in EO-FGR. Logistic regression analysis of UA absent or reversed end diastolic flow (EDF), abnormal DV Doppler, and absent/reversed DV a-wave revealed Odds Ratios of 2.57, 6.97, 4.51 and 8.75 respectively for perinatal mortality in EO-FGR. The incidence of CPR below the 5 th percentile was significantly higher in LO-FGR pregnancies with the composite adverse outcome than normal outcome (p<0.001). Conclusion:Gestational age at delivery and birth weight are the strongest predictors of perinatal mortality in EO-FGR. In LO-FGR, CPR <5 th percentile is associated with an increased risk of delivery complications.

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Section: Discussionsupporting

confidence: 86%

Perinatal Outcomes and Prognostic Factors in Early and Late-Onset Fetal Growth Restriction

Madazli¹,

Alpay²,

Kaymak³

et al. 2022

J Istanb Fac Med

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“…We used the lasso regression to screen out variates, indicating that aspirin did not decrease the risk of fetal distress for fetal growth restriction. Our research tentatively studied that the gestational week decreases would increase the incidence of admission to NICU after birth (P < 0.001), which was similar to the research [22]. The fetus of FGR patients with HDP, ICP was easier to entry into the NICU (P=0.032, P=0.011).…”

Section: Discussionsupporting

confidence: 77%

Predicting Fetal Distress and Admission to Neonatal Intensive Care Unit in Patients With Fetal Growth Restriction by Nomogram: A Retrospective Cohort Study in China

Chen¹,

Chen²,

Jiang³

et al. 2020

Preprint

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Background: The purpose of this research was to establish prediction model of fetal distress risk and admission to neonatal intensive care unit(NICU) risk in a Chinese population of patients with fetal growth restriction(FGR), to provide a reliable basis for clinical management. Methods: A retrospective analysis of 930 patients were delivered with FGR in the obstetrics and gynecology hospital affiliated from January 1, 2014 to December 30, 2019 at Women’s Hospital, School of Medicine, Zhejiang University, in Hangzhou, and screened out the independent predictors affecting fetal distress and admission to NICU using lasso regression. Multivariable logistic regression analysis was used to establish the nomogram prediction model of fetal distress risk and admission to NICU risk. Discrimination of the predicting model was assessed by the C-index and receiver operating characteristic (ROC) curve, using the bootstrapping validation and the ROC curve to evaluate the Internal validation. Calibration and clinical usability of the predicting model were respectively adopted by calibration curves and decision curve analysis. Internal validation was assessed using the bootstrapping validation. Results: We found that six identified factors associated with fetal distress of patients with FGR: age, gestational week, delivery method, placenta previa, abnormal cord blood flow, and using low molecular weight heparin(LMWH). The application of LMWH during pregnancy could reduce the incidence of fetal distress. Four independent predictors were selected for admission to NICU of patients with FGR: gestational week, delivery method, hypertensive disorders of pregnancy, and intrahepatic cholestasis of pregnancy. The delivery method of cesarean section increased the above risks. Two nomograms were developed and verified accordingly. The two models had good discrimination and good calibration respectively. The decision curve analysis performed that the clinical usability and benefits of the nomograms were the range of 3%-75% and 17%-95%. Conclusions: Two nomograms were the first to predict fetal distress and admission to NICU of patients with FGR. Establishing effective predictive models based on independent predictors could help early diagnosis and evaluation of fetal distress and admission to NICU in patients with FGR.

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“…However, by and large, the studies included both term small-for-gestational-age and preterm newborns, making no distinction between them. (4,5) Considering this reality and the scarcity of studies in this context, it becomes relevant to understand the impact of prematurity associated with birth weight deficit on the postnatal progression of these patients.…”

Section: ❚ Introductionmentioning

confidence: 99%

In-hospital outcomes in preterm and small-for-gestational-age newborns: a cohort study

Costa

Valete³

et al. 2022

Einstein (São Paulo)

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Objective: To compare in-hospital outcomes between small-for-gestational-age and appropriatefor-gestational-age preterm neonates who needed intensive care. Methods: A retrospective cohort study with preterm newborns, from January to December 2017. The results are presented as median, frequency, and odds ratio. Numerical variables were compared using the Wilcoxon test. Categorical variables were compared using the χ 2 test. We considered p<0.05 as significant. Results: Out of 129 preterm newborns included, 20.9% were small-for-gestationalage. Median gestational age was 31 2/7 weeks, birthweight was 1,450g, and length of hospital stay was 39 days. Preterm small-for-gestational-age newborns presented a higher chance of peri-intraventricular hemorrhage (odds ratio of 3.23; p=0.02), retinopathy of prematurity (odds ratio of 2.78 p=0.02), patent ductus arteriosus (odds ratio of 2.50; p=0.04) and a lower chance of presumptive early-onset sepsis (odds ratio of 0.37; p=0.03). Conclusion: Preterm small-forgestational-age neonates were associated with peri-intraventricular hemorrhage, retinopathy of prematurity and patent ductus arteriosus. This emphasizes the need of special care for these neonates.

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Perinatal Outcomes of Fetuses with Early Growth Restriction, Late Growth Restriction, Small for Gestational Age, and Adequate for Gestational Age

Cited by 8 publications

References 27 publications

Perinatal Outcomes and Prognostic Factors in Early and Late-Onset Fetal Growth Restriction

Perinatal Outcomes and Prognostic Factors in Early and Late-Onset Fetal Growth Restriction

Predicting Fetal Distress and Admission to Neonatal Intensive Care Unit in Patients With Fetal Growth Restriction by Nomogram: A Retrospective Cohort Study in China

In-hospital outcomes in preterm and small-for-gestational-age newborns: a cohort study

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