Fetal growth patterns in women with preeclampsia: Insights from the REVAMP study

To examine fetal growth patterns in preeclampsia (PE) and compare them with a control, low-risk Indian population.

Prospective longitudinal observational study.

Fetal biometry measurements were undertaken at various time points across pregnancy. Ultrasound scans measured, crown-rump length (CRL) at 11-14 weeks and biparietal diameter (BPD), femur length (FL), head and abdominal circumference (HC and AC), and estimated fetal weight (FWT) during the mid (18-22 weeks) and late (32-35 weeks) gestation. Z-scores with 95 % CIs were calculated using the low-risk group as a reference. Fetal growth centile curves were developed using GAMLSS and evaluated against low-risk group centiles.

The study included 106 low-risk population and 92 PE women. 'Low-risk' pregnancies defined using Intergrowth-21st criteria. At 11-14 weeks, CRL Z-scores were similar between low-risk and PE groups. At 18-22 weeks, PE fetuses had lower Z-scores for BPD [-0.36 SD (95 % CI: (-0.61, -0.11)], AC [-0.41 SD (95 % CI: (-0.66, -0.19)], HC [-0.62 SD (95 % CI: -0.90, -0.35)], FL [-0.49 SD (95 % CI: -0.74, -0.25)], and FWT [-0.54 SD (95 % CI: -0.78, -0.32)] compared to low-risk group. At 32-35 weeks, differences in mean Z-scores were no longer statistically significant, but PE fetuses consistently showed lower centile values throughout gestation.

Fetuses in PE group exhibited lower biometric Z-scores for BPD, AC, HC, and FL at 18-22 weeks, indicating early growth restriction. PE fetuses remained at lower percentiles even at 32-35 weeks suggesting a sustained impact on fetal growth pattern.