Fetal Growth Restriction Prevention: Is There a Role for Aspirin, Heparin, Statins, and Others?

Area of Science:

• Obstetrics and Gynecology
• Perinatal Medicine
• Maternal-Fetal Medicine

Background:

• Fetal Growth Restriction (FGR) impacts up to 10% of pregnancies, contributing significantly to perinatal complications.
• Placental dysfunction is a key factor in FGR, leading to adverse fetal outcomes and mortality.

Purpose of the Study:

• To review current and emerging therapeutic strategies for preventing and treating placental-mediated FGR.
• To identify the most evidence-based interventions for FGR management.

Main Methods:

• Literature review of studies on FGR therapies.
• Analysis of evidence for interventions including aspirin, heparin, and novel agents.
• Exploration of shared pathophysiology between FGR and preeclampsia.

Main Results:

• Low-dose aspirin initiated prior to 16 weeks of gestation demonstrates the strongest evidence of efficacy.
• Interventions such as low-molecular-weight heparin, PDE-5 inhibitors, statins, nitric oxide donors, VEGF gene therapy, melatonin, and IGF-based strategies are currently investigational.
• Shared pathophysiological mechanisms with preeclampsia suggest potential for early intervention.

Conclusions:

• Early initiation of low-dose aspirin is a recommended therapy for FGR.
• Further research is needed to develop targeted therapies for improving placental function and fetal outcomes in FGR.
• Risk stratification is crucial for optimizing FGR management and improving perinatal results.