Third trimester growth restriction patterns: individualized assessment using a fetal growth pathology score

Area of Science:

• Fetal Medicine
• Neonatalogy
• Quantitative Biology

Background:

• Fetal growth restriction (FGR) affects fetal development, necessitating accurate characterization of growth patterns.
• Understanding FGR progression is crucial for predicting neonatal outcomes and guiding interventions.

Purpose of the Study:

• To qualitatively and quantitatively characterize third-trimester growth patterns in fetuses with growth restriction.
• To utilize Individualized Growth Assessment methods for detailed FGR pattern analysis.

Main Methods:

• Employed the Fetal Growth Pathology Score (FGPS1), a novel composite parameter, to evaluate serial fetal size measurements in 73 fetuses with FGR.
• Analyzed FGPS1 components (head circumference, abdominal circumference, femur diaphysis length, estimated weight) and growth abnormality characteristics (onset, duration, magnitude).

Main Results:

• Identified five distinct FGR patterns in 95.9% of cases, with progressive worsening (Pattern 1) and late-onset, short-duration (Pattern 2) being most common.
• Abnormalities in abdominal circumference and estimated weight were most significant contributors to FGR patterns.
• MANOVA and GLM analyses revealed statistically significant differences between patterns regarding size abnormalities and growth process characteristics.

Conclusions:

• The study identified five repetitive patterns of third-trimester FGR, indicating diverse evolutionary pathways for this condition.
• This detailed evaluation, considering individual fetal growth potential, is the first of its kind.
• Further research is warranted to correlate these patterns with physiological changes and adverse outcomes.