Predictive Factors for Fetal Growth Restriction in Patients with Preeclampsia: A Clinical Prediction Study

Area of Science:

• Obstetrics and Gynecology
• Maternal-Fetal Medicine
• Neonatology

Background:

• Preeclampsia (PE) is a major pregnancy complication with significant risks for maternal and fetal health, especially fetal growth restriction (FGR).
• Early identification of FGR risk factors in PE patients is crucial for timely intervention and improved neonatal outcomes.

Purpose of the Study:

• To identify independent risk factors for FGR in pregnancies complicated by preeclampsia.
• To develop and validate a predictive nomogram for FGR in PE patients.

Main Methods:

• Retrospective case-control study of 714 singleton pregnancies with preeclampsia.
• Least Absolute Shrinkage and Selection Operator (LASSO) logistic regression for risk factor identification.
• Development and validation of a predictive nomogram using training and validation cohorts.

Main Results:

• Nine significant predictors for FGR in PE patients were identified, including family history of hypertension, AST, uric acid, mode of delivery, MPV, PT, PE severity, post-pregnancy weight, and gestational age.
• The nomogram demonstrated excellent predictive performance (AUC 0.93 in training, 0.90 in validation).
• Calibration and decision curve analyses confirmed the nomogram's clinical utility and reliability.

Conclusions:

• The developed nomogram is a reliable tool for predicting FGR in preeclampsia.
• Clinical application of this nomogram can enhance decision-making and improve fetal outcomes.
• Further validation in diverse populations is recommended to broaden its clinical applicability.