The impact of fetal growth restriction in diagnosing preeclampsia on the severity of maternal features

Abstract

Aim: We aimed to assess the impact of fetal growth restriction (FGR) as a diagnostic criterion for preeclampsia (PE) on the severity of maternal preeclamptic features by comparing it with other diagnostic criteria for PE, maternal organ dysfunction. Methods: We performed a retrospective cohort study of singleton pregnancies. Based on the status at diagnosis, PE cases preceded by FGR without maternal organ dysfunction (Group F; n = 28) and those preceded by maternal organ dysfunction without FGR (Group M; n = 87) were analyzed. Results: Group F had an earlier PE diagnosis (32.5 AE 4.9 vs. 36.7 AE 3.5 weeks, p < 0.01) and delivery (33.7 AE 4.5 vs. 37.5 AE 3.1 weeks, p < 0.01) than Group M. No significant differences in maternal morbidities were observed between the groups, including severe hypertension (75.0 vs. 60.0%), need for intravenous antihypertensives (42.9 vs. 48.3%) or magnesium sulfate (60.7 vs. 54.5%), or a composite of major maternal complications (17.9 vs. 21.8%). When limited to early-onset PE diagnosed before 34 weeks of gestation (17 and 17 cases in Group F and M, respectively), the frequencies of maternal morbidities (severe hypertension: 70.6 vs. 52.9%, intravenous antihypertensives: 35.3 vs. 35.3%, magnesium sulfate: 58.8 vs. 47.1%, major complications: 29.4 vs. 23.5%) and the duration from diagnosis until delivery (11.2 AE 14.7 vs. 16.5 AE 21.7 days) were comparable between two groups. Conclusions: Our results suggest that the presence of FGR on PE diagnosis is associated with the development of severe maternal symptoms as much as that of maternal organ dysfunction at diagnosis, and it may be reasonable to include FGR in PE diagnostic criteria.

[Retracted] Clinical Value of Serum SIRT1 Combined with Uterine Hemodynamics in Predicting Disease Severity and Fetal Growth Restriction in Preeclampsia

“…According to relevant data, the incidence of preeclampsia can reach 7% [5]. Fetal growth restriction (FGR) is mainly due to the low invasive ability of trophoblast cells and poor remodeling of the uterine spiral artery, which leads to placental ischemia and hypoxia, which afects fetal development [6,7]. Preeclampsia combined with FGR is relatively common, the onset of gestational age is generally earlier, the functional development of fetal organs is immature, and the incidence of adverse pregnancy outcomes is high [8,9].…”

Preeclampsia, Fetal Growth Restriction, and 24-Month Neurodevelopment in Very Preterm Infants

“…It is understood that infants born to mothers with preeclampsia are at increased risk of FGR, and in cases of severe preeclampsia, the risk of FGR is even greater. 59 FGR may be a late marker of preeclampsia severity, 60 with deleterious effects on delivery of nutrition and oxygen to the fetus. Therefore, the presence of FGR may have differing long-term implications for an infant than an early diagnosis of preeclampsia without FGR.…”