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Perinatal Adverse Effects in Newborns with Estimated Loss of Weight Percentile between the Third Trimester Ultrasound

María Sonsoles Galán Arévalo1, Ignacio Mahillo-Fernández2, Luis Mariano Esteban3

  • 1Department of Neonatology, Villalba University General Hospital, 28400 Madrid, Spain.

Journal of Clinical Medicine
|October 23, 2021
PubMed

Insights

Small-for-gestational-age (SGA) newborns not experiencing fetal growth deceleration (FGD) have the highest risk of adverse perinatal outcomes (APOs). Appropriate-for-gestational-age (AGA) newborns with FGD show no increased APO risk, but may need cesarean delivery for non-reassuring fetal status.

Area of Science:

  • Perinatal Medicine
  • Neonatalogy
  • Obstetrics

Background:

  • Fetal growth restriction is linked to adverse perinatal outcomes (APOs).
  • The impact of fetal growth deceleration (FGD) on APOs in small-for-gestational-age (SGA) and appropriate-for-gestational-age (AGA) newborns requires further clarification.

Purpose of the Study:

  • To determine the significance of late-gestation fetal growth deceleration (FGD) for adverse perinatal outcomes (APOs).
  • To compare APO risks between SGA and AGA newborns with and without FGD.

Main Methods:

  • Retrospective cohort study of 1067 singleton pregnancies.
  • Analysis of adverse perinatal outcomes (APOs) in relation to SGA/AGA status and fetal growth deceleration (FGD).

Main Results:

  • Newborns with the highest APO rates were SGA non-FGD (40.9%) and SGA FGD (31.5%).
  • SGA non-FGD was associated with a significantly increased risk of any APO (OR 2.61).
  • AGA FGD newborns did not show increased APO risk, except for cesarean delivery due to non-reassuring fetal status (NRFS) with percentile cutoffs >40 or >50.

Conclusions:

  • Newborns who are SGA and non-FGD have the highest probability of adverse perinatal outcomes.
  • AGA FGD newborns do not exhibit a higher incidence of APOs compared to AGA non-FGD newborns.
  • Close surveillance is warranted for newborns at risk, particularly those with significant percentile drops, to prevent adverse outcomes.

Keywords:
adverse perinatal outcomesbirthweightestimated fetal weightestimated percentile weightfetal growth velocitygestational agenewborn

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