Fetal growth impairment after first-trimester chorionic villus sampling: a case-control study

Area of Science:

• Perinatal Medicine
• Maternal-Fetal Medicine
• Obstetrics

Background:

• Chorionic villus sampling (CVS) is a common prenatal diagnostic procedure.
• Potential risks of CVS, such as fetal growth impairment, require thorough investigation.
• Controlling for maternal and fetal factors is crucial in assessing the safety of CVS.

Purpose of the Study:

• To determine if chorionic villus sampling (CVS) is associated with fetal growth impairment.
• To investigate the relationship between CVS and adverse pregnancy outcomes, including preeclampsia.
• To identify predictors of fetal growth restriction and preeclampsia in a cohort undergoing CVS.

Main Methods:

• A case-control study comparing singleton fetuses of mothers who underwent CVS (N=442) with a control group (N=2969).
• Primary outcomes included birthweight below the 10th and 3rd centiles.
• Logistic regression analysis was used to assess predictors including CVS, hormone levels (free beta-hCG MoMs, PAPP-A MoMs), uterine artery pulsatility index (PI) z-scores, and maternal factors (height, BMI, age, smoking).

Main Results:

• No significant difference in the prevalence of birthweight <10th centile (7.9% vs 6.2%) or <3rd centile (1.6% vs 1.1%) between the CVS and control groups.
• Maternal age, smoking, PAPP-A MoMs, and uterine PI z-scores were significant predictors of low birthweight.
• Preeclampsia was more prevalent in the CVS group (3.2% vs 1.3%), but this association was not significant after adjusting for maternal BMI, free b-hCG, and uterine PI z-scores in regression analysis.

Conclusions:

• Chorionic villus sampling (CVS) is not associated with an increased risk of fetal growth impairment.
• The developing placenta may compensate for any mechanical disruption caused by CVS, maintaining normal placental function.
• Further research may explore the placental compensatory mechanisms in response to CVS.