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Published on: November 20, 2015
Early adverse perinatal complications in preterm growth-restricted fetuses
Mellisa Damodaram1, Lisa Story, Elena Kulinskaya
1Centre for Fetal Care, Imperial College, London, UK.
Insights
Preterm fetuses with fetal growth restriction face significantly higher risks for adverse perinatal outcomes, including death and major complications. These risks, though decreasing with gestational age, remain elevated compared to normally grown fetuses.
Area of Science:
- Perinatal Medicine
- Neonatology
- Fetal Medicine
Background:
- Fetal growth restriction (FGR) is linked to adverse perinatal outcomes.
- The specific risks for preterm FGR fetuses are not well-defined.
- This study quantifies risks for preterm FGR.
Purpose of the Study:
- To quantify the additional perinatal risks for preterm fetuses with FGR.
- To provide data for parental counseling regarding FGR complications.
Main Methods:
- Meta-analysis and meta-regression.
- Inclusion of studies published since 1997.
- Focus on perinatal outcomes in preterm FGR.
Main Results:
- Preterm FGR fetuses have increased risks for low Apgar scores, sepsis, intracranial hemorrhage, and death.
- Necrotizing enterocolitis and respiratory complications are also more frequent.
- Risk amplification persists even as gestational age increases.
Conclusions:
- This meta-analysis quantifies the heightened perinatal risks associated with preterm FGR.
- Findings can inform parental counseling on potential neonatal complications.
Introduction:
Growth-restricted fetuses are at increased risk of adverse perinatal outcome when compared to their normally grown counterparts. The additional risks associated with growth restriction in preterm fetuses are not well quantified, and this meta-analysis serves to address this uncertainty.
Materials And Methods:
This is a meta-analysis and meta-regression of all relevant studies published since 1997 investigating perinatal outcome in preterm growth-restricted fetuses.
Results:
Growth-restricted fetuses across all gestational ages were found to be at significant risk of having low Apgar scores at 5 min, sepsis, intracranial haemorrhage, intrauterine and neonatal death, necrotising enterocolitis and respiratory complications. Although this risk reduced as gestation increased, it remained amplified in growth-restricted fetuses when compared to normally grown fetuses.
Conclusion:
This large meta-analysis for the first time quantifies the additional perinatal risks associated with preterm fetal growth restriction and may help counsel parents about the complications these fetuses face following birth.
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