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Doppler abnormality predisposes preterm infants with fetal growth restriction to postnatal intestinal disorder

Tomohiro Ohtani1, Mari Ichinose1, Yu Ariyoshi1

  • 1Department of Obstetrics and Gynecology, Faculty of Medicine, The University of Tokyo, Tokyo, Japan.

The Journal of Obstetrics and Gynaecology Research
|September 15, 2025
PubMed

Insights

Fetal growth restriction (FGR) and prolonged umbilical Doppler abnormalities may increase the risk of intestinal disorders (ID) in preterm infants. A stressed intrauterine environment may lead to increased postnatal intestinal vulnerability.

Area of Science:

  • Neonatal Medicine
  • Perinatal Research
  • Pediatric Surgery

Background:

  • Intestinal disorders (ID) significantly impact preterm infants, with conditions like necrotizing enterocolitis (NEC), meconium-related ileus (MRI), and focal intestinal perforation (FIP) posing major challenges.
  • While individual risk factors for specific IDs are known, the overall etiology of ID in preterm infants remains incompletely understood.
  • Identifying overarching obstetric risk factors is crucial for improving outcomes in this vulnerable population.

Purpose of the Study:

  • To investigate potential obstetric risk factors associated with the development of intestinal disorders (ID) in preterm infants.
  • To explore the relationship between fetal growth restriction (FGR) and the incidence of ID.
  • To examine the impact of prolonged Doppler abnormalities on ID development.

Main Methods:

  • Retrospective analysis of singleton preterm infants (22 0/7 to 28 6/7 weeks gestation) born between 2013 and 2022 without congenital anomalies.
  • Comparison of obstetric factors, including maternal background, complications, FGR, chorioamnionitis, Apgar score, and umbilical artery blood gas, between infants with ID and a control group.
  • Statistical analysis to determine the significance of identified risk factors.

Main Results:

  • Out of 119 preterm infants, 22 (18.5%) developed ID, encompassing MRI (14), FIP (4), and NEC (5).
  • Fetal growth restriction (FGR) was significantly more prevalent in the ID group (45.5%) compared to the non-ID group (23.7%, p=0.047).
  • Infants with ID and FGR exhibited a significantly longer interval from the onset of Doppler abnormalities to delivery (180 hours) than those without ID (24 hours, p=0.049).

Conclusions:

  • Fetal growth restriction (FGR) is a potential risk factor for intestinal disorders (ID) in preterm infants.
  • This study is the first to link prolonged umbilical Doppler abnormalities to the development of ID, suggesting a role for chronic intrauterine stress.
  • Findings indicate that a compromised intrauterine environment may heighten intestinal vulnerability in preterm neonates post-birth.
Abstract

Keywords:
Doppler abnormalityfetal growth restrictionintestinal disordersintrauterine environmentpreterm birth

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