Growth restriction: identifying fetuses at risk

Area of Science:

• Perinatal Medicine
• Fetal Growth Assessment
• Diagnostic Ultrasound

Background:

• Intrauterine growth restriction (IUGR) and small for gestational age (SGA) fetuses are associated with increased perinatal morbidity.
• Accurate identification of at-risk fetuses is crucial for timely intervention.

Purpose of the Study:

• To examine the risks of IUGR and composite perinatal outcomes in fetuses with estimated fetal weights (EFW) between the 10th and 20th percentiles.
• To compare these outcomes based on umbilical artery Doppler (UAD) findings.

Main Methods:

• Retrospective cohort study of ultrasound (US) data from 2002-2012.
• Cases with EFW between the 10th-20th percentiles were matched with controls (EFW >20th percentile) by gestational age and US date.
• Logistic regression analysis was used to assess outcomes.

Main Results:

• Fetuses with EFW 10th-20th percentile showed significantly increased risks of IUGR (OR 26.5), SGA (OR 9.2), NICU admissions (OR 2.4), and composite perinatal morbidity (OR 7.8) after adjustment.
• Abnormal UAD in this group was associated with higher rates of low 5-min Apgar scores, NICU admission, and composite morbidity.

Conclusions:

• Pregnancies with EFW 10th-20th percentile are at elevated risk for IUGR, SGA, NICU admission, and composite perinatal outcomes.
• Abnormal umbilical artery Doppler findings in these fetuses indicate a further increased risk of adverse outcomes.