Fetal Growth Restriction as the Initial Finding of Preeclampsia is a Clinical Predictor of Maternal and Neonatal Prognoses: A Single-center Retrospective Study

Abstract Background: Preeclampsia (PE) is a hypertensive disorder specific to pregnancy, which sometimes causes severe maternal-neonatal complications. The International Society for the Study of Hypertension in Pregnancy revised their criteria for PE in 2018; a PE diagnosis can be established in the absence of proteinuria when other specific symptoms exist, such as other organ dysfunction or uteroplacental dysfunction. Therefore, the initial findings of PE (IFsPE) at the first diagnosis can vary considerably across patients. However, there are no reports on patients with PE based on different IFsPE and their impact on patients’ clinical outcomes. Thus, we aimed to investigate the predictors of maternal and neonatal outcomes based on IFsPE according to the new criteria.Methods: This was a retrospective study involving 3729 women who delivered at our hospital between 2015 and 2019. All women were reclassified based on the new criteria. They were divided into three groups based on the IFsPE: Classification 1 (C-1), proteinuria (classical criteria); Classification 2 (C-2), damage to other maternal organs; and Classification 3 (C-3), uteroplacental dysfunction. Maternal and fetal conditions and perinatal outcomes were assessed in the three groups.Results: In total, 104 women with PE were included. Of those, 42 (40.4%), 28 (26.9%), and 34 (32.7%) were assigned to C-1, C-2, and C-3 groups, respectively. All women in C-3 showed fetal growth restriction (FGR). The number of gestational weeks at PE diagnosis and delivery was significantly lower in the C-3 group (C-1, 35.5±3.0 weeks; C-2, 35.2±3.6 weeks; C-3, 31.6±4.6 weeks, P < 0.01; and C-1, 36.8±2.8 weeks; C-2, 36.3±3.2 weeks; C-3, 33.4±4.4 weeks, P < 0.01, respectively). The rates of preterm delivery at < 34 weeks (odds ratio [OR]=4.58 [1.74-12.10] and OR=2.83 [1.01-7.97]), cesarean delivery (OR=4.35 [1.41-13.45] and OR=5.03 [1.51-16.78]), Apgar scores < 7 at 1 min (OR=6.58 [2.08-20.80] and OR=4.09 [1.26-13.29]), neonatal intensive care unit admission (OR=12.19 [3.62-41.08], OR=7.50 [2.09-26.96]), and composite neonatal complications (OR=6.58 [2.08-20.80] and OR=5.33 [1.52-18.70]) were significantly higher in the C-3 group than in the C-1 and C-2 groups.Conclusions: PE patients with FGR had the most unfavorable prognosis for both maternal and neonatal outcomes.

Download Full-text

Maternal and neonatal outcomes of pregnancies complicated by late fetal growth restriction undergoing induction of labor with dinoprostone compared with cervical balloon: A retrospective, international study

Acta Obstetricia Et Gynecologica Scandinavica ◽

10.1111/aogs.14135 ◽

2021 ◽

Author(s):

Daniele Di Mascio ◽

Cecilia Villalain ◽

Giuseppe Rizzo ◽

Jose Morales‐Rossello ◽

Filomena G. Sileo ◽

...

Keyword(s):

Fetal Growth ◽

Fetal Growth Restriction ◽

International Study ◽

Induction Of Labor ◽

Growth Restriction ◽

Neonatal Outcomes ◽

Maternal And Neonatal Outcomes

Download Full-text

423: Does fetal growth restriction predict adverse maternal and neonatal outcomes in women with preeclampsia?

American Journal of Obstetrics and Gynecology ◽

10.1016/j.ajog.2014.10.469 ◽

2015 ◽

Vol 212 (1) ◽

pp. S219-S220

Author(s):

Kathryn Sharma ◽

Tania Esakoff ◽

Alyson Guillet ◽

Richard Burwick ◽

Aaron Caughey

Keyword(s):

Fetal Growth ◽

Fetal Growth Restriction ◽

Growth Restriction ◽

Neonatal Outcomes ◽

Maternal And Neonatal Outcomes

Download Full-text

Fetal growth restriction as the initial finding of preeclampsia is a clinical predictor of maternal and neonatal prognoses: a single-center retrospective study

BMC Pregnancy and Childbirth ◽

10.1186/s12884-021-04152-2 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Masaya Takahashi ◽

Shintaro Makino ◽

Kyoko Oguma ◽

Haruka Imai ◽

Ai Takamizu ◽

...

Keyword(s):

Retrospective Study ◽

Fetal Growth ◽

Pregnancy Outcomes ◽

Pregnancy Complications ◽

Fetal Growth Restriction ◽

Premature Birth ◽

Adverse Pregnancy Outcomes ◽

Growth Restriction ◽

Hypertensive Disorder ◽

Adverse Pregnancy

Abstract Background Preeclampsia (PE) is a hypertensive disorder specific to pregnancy that can cause severe maternal-neonatal complications. The International Society for the Study of Hypertension in Pregnancy revised the PE criteria in 2018; a PE diagnosis can be established in the absence of proteinuria when organ or uteroplacental dysfunction occurs. The initial findings of PE (IFsPE) at the first diagnosis can vary considerably across patients. However, the impacts of different IFsPE on patient prognoses have not been reported. Thus, we investigate the predictors of pregnancy complications and adverse pregnancy outcomes based on IFsPE according to the new criteria. Methods This retrospective study included 3729 women who delivered at our hospital between 2015 and 2019. All women were reclassified based on the new PE criteria and divided into three groups based on the IFsPE: Classification 1 (C-1), proteinuria (classical criteria); Classification 2 (C-2), damage to other maternal organs; and Classification 3 (C-3), uteroplacental dysfunction. Pregnancy complications and adverse pregnancy outcomes were assessed and compared among the three groups. Results In total, 104 women with PE were included. Of those, 42 (40.4%), 28 (26.9%), and 34 (32.7%) were assigned to C-1, C-2, and C-3 groups, respectively. No significant differences in maternal characteristics were detected among the three groups, except for gestational age at PE diagnosis (C-1, 35.5 ± 3.0 weeks; C-2, 35.2 ± 3.6 weeks; C-3, 31.6 ± 4.6 weeks, p < 0.01). The rates of premature birth at < 37 weeks of gestation, fetal growth restriction (FGR), and neonatal acidosis were significantly higher in the C-3 group compared to the C-1 and C-2 groups. Additionally, the composite adverse pregnancy outcomes of the C-3 group compared with C-1 and C-2 represented a significantly higher number of patients. Conclusions PE patients with uteroplacental dysfunction as IFsPE had the most unfavorable prognoses for premature birth, FGR, acidosis, and composite adverse pregnancy outcomes.

Download Full-text

Gestational iron deficiency anemia is associated with preterm birth, fetal growth restriction, and postpartum infections

Journal of Perinatal Medicine ◽

10.1515/jpm-2020-0379 ◽

2020 ◽

Vol 0 (0) ◽

Author(s):

Lotta Kemppinen ◽

Mirjami Mattila ◽

Eeva Ekholm ◽

Nanneli Pallasmaa ◽

Ari Törmä ◽

...

Keyword(s):

Preterm Birth ◽

Fetal Growth ◽

Fetal Growth Restriction ◽

Iron Supplementation ◽

Reference Group ◽

Intravenous Iron ◽

Growth Restriction ◽

Neonatal Outcomes ◽

Maternal And Neonatal Outcomes ◽

Intravenous Iron Supplementation

AbstractObjectivesGestational IDA has been linked to adverse maternal and neonatal outcomes, but the impact of iron supplementation on outcome measures remains unclear. Our objective was to assess the effects of gestational IDA on pregnancy outcomes and compare outcomes in pregnancies treated with either oral or intravenous iron supplementation.MethodsWe evaluated maternal and neonatal outcomes in 215 pregnancies complicated with gestational IDA (Hb<100 g/L) and delivered in our tertiary unit between January 2016 and October 2018. All pregnancies from the same period served as a reference group (n=11,545). 163 anemic mothers received oral iron supplementation, and 52 mothers received intravenous iron supplementation.ResultsGestational IDA was associated with an increased risk of preterm birth (10.2% vs. 6.1%, p=0.009) and fetal growth restriction (FGR) (1.9% vs. 0.3%, p=0.006). The gestational IDA group that received intravenous iron supplementation had a greater increase in Hb levels compared to those who received oral medication (18.0 g/L vs. 10.0 g/L, p<0.001), but no statistically significant differences in maternal and neonatal outcomes were detected.ConclusionsCompared to the reference group, prematurity, FGR, postpartum infections, and extended hospital stays were more common among mothers with gestational IDA, causing an additional burden on the families and the healthcare system.

Download Full-text

824 Prediction of perinatal demise and severe adverse neonatal outcomes in pregnancies with fetal growth restriction

American Journal of Obstetrics and Gynecology ◽

10.1016/j.ajog.2020.12.847 ◽

2021 ◽

Vol 224 (2) ◽

pp. S513-S514

Author(s):

Emily W. Zantow ◽

Jennifer E. Powel ◽

Samantha J. Mullan ◽

Megan L. Lawlor ◽

Kia Lannaman ◽

...

Keyword(s):

Fetal Growth ◽

Fetal Growth Restriction ◽

Growth Restriction ◽

Neonatal Outcomes ◽

Adverse Neonatal Outcomes

Download Full-text

OP14.07: Accuracy of ultrasound estimation of fetal weight and diagnosis of fetal growth restriction in gastroschisis: a retrospective study

Ultrasound in Obstetrics and Gynecology ◽

10.1002/uog.19519 ◽

2018 ◽

Vol 52 ◽

pp. 107-107

Author(s):

A.J. Ryan ◽

M. Atkinson ◽

S. Benjamin ◽

S.J. Melov ◽

I. Alahakoon

Keyword(s):

Retrospective Study ◽

Fetal Growth ◽

Fetal Growth Restriction ◽

Growth Restriction ◽

Fetal Weight

Download Full-text

Placental Pathologic Changes Associated with Fetal Growth Restriction and Consequent Neonatal Outcomes

Fetal and Pediatric Pathology ◽

10.1080/15513815.2020.1723147 ◽

2020 ◽

pp. 1-12

Author(s):

Do Hwa Im ◽

Young Nam Kim ◽

Hwa Jin Cho ◽

Yong Hee Park ◽

Da Hyun Kim ◽

...

Keyword(s):

Fetal Growth ◽

Fetal Growth Restriction ◽

Growth Restriction ◽

Neonatal Outcomes

Download Full-text

Prediction of late-onset fetal growth restriction using a combined first- and second-trimester screening model in South Chinese infants: a retrospective study

10.21203/rs.2.17844/v1 ◽

2019 ◽

Author(s):

Haiqing Zheng ◽

Yan Feng ◽

Jiexin Zhang ◽

Kuanrong Li ◽

Huiying Liang ◽

...

Keyword(s):

Retrospective Study ◽

Birth Weight ◽

Fetal Growth ◽

Fetal Growth Restriction ◽

Detection Rate ◽

Prediction Models ◽

Late Onset ◽

Growth Restriction ◽

Abdominal Circumference ◽

Second Trimester

Abstract Background Prediction models for early and late fetal growth restriction (FGR) have been established in many high-income countries. However, prediction models for late FGR in China are limited. This study aimed to develop a simple combined first- and second-trimester prediction model for screening late-onset FGR in South Chinese infants.Methods This retrospective study included 2258 women who had singleton pregnancies and received routine ultrasound scans. Late-onset FGR was defined as a birth weight < the 10th percentile plus abnormal Doppler indices and/or a birth weight below the 3rd percentile after 32 weeks, regardless of the Doppler status. Multivariate logistic regression was used to develop a prediction model.Results Ninety-three fetuses were identified as late-onset FGR. The significant predictors for late-onset FGR were maternal age, height, weight, and medical history; the second-trimester head circumference (HC)/abdominal circumference (AC) ratio; and the estimated fetal weight (EFW). This model achieved a detection rate (DR) of 52.6% for late-onset FGR at a 10% false positive rate (FPR) (area under the curve (AUC): 0.80, 95%CI 0.76-0.85).Conclusions A multivariate model combining first- and second-trimester default tests can detect 52.6% of cases of late-onset FGR. Further studies with more screening markers are needed to improve the detection rate.

Download Full-text

Occupational Exposure to Ultrafine Particles and Placental Histopathological Lesions: A Retrospective Study about 130 Cases

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph182312719 ◽

2021 ◽

Vol 18 (23) ◽

pp. 12719

Author(s):

Anaïs Pasquiou ◽

Fanny Pelluard ◽

Guyguy Manangama ◽

Patrick Brochard ◽

Sabyne Audignon ◽

...

Keyword(s):

Retrospective Study ◽

Occupational Exposure ◽

Fetal Growth ◽

Human Activities ◽

Fetal Growth Restriction ◽

Ultrafine Particles ◽

Growth Restriction ◽

Natural Phenomena ◽

Job Exposure Matrix ◽

Histopathological Lesions

Ultrafine particles (UFPs) are particles smaller than 100 nanometers that are produced unintentionally during human activities or natural phenomena. They have a higher biological reactivity than bigger particles and can reach the placenta after maternal exposure. One study has shown an association between maternal occupational exposure to UFPs and fetal growth restriction. Yet few studies have focused on the effects of UFP exposure on placental histopathological lesions. The aim of this study was to investigate the association between maternal occupational exposure to UFPs and histopathological lesions of their placenta. The analyses were based on data from the ARTEMIS Center. A job-exposure matrix was used to assess occupational exposure to UFPs. The histopathological placental exam was performed by two pathologists who were blinded to the exposure of each subject. The examination was conducted in accordance with the recommendations of the Amsterdam consensus. The study sample included 130 placentas (30 exposed, 100 unexposed). Maternal occupational exposure to UFPs during pregnancy is significantly associated with placental hypoplasia (the phenomenon affected 61% of the exposed patients and 34% of the unexposed ones, p < 0.01). Further research is needed to explain its pathophysiological mechanisms.

Download Full-text