Daily Ards Research Analysis
Today's scan surfaced a single prospective observational study examining maternal risk factors and perinatal outcomes among fetuses with fetal growth restriction (FGR). The study highlights advanced maternal age and hypertensive disorders of pregnancy as key correlates of severe FGR and quantifies neonatal morbidity and NICU utilization.
Summary
Today's scan surfaced a single prospective observational study examining maternal risk factors and perinatal outcomes among fetuses with fetal growth restriction (FGR). The study highlights advanced maternal age and hypertensive disorders of pregnancy as key correlates of severe FGR and quantifies neonatal morbidity and NICU utilization.
Research Themes
- Risk stratification in fetal growth restriction
- Impact of maternal comorbidities (hypertension) on neonatal outcomes
- Perinatal resource planning and NICU utilization
Selected Articles
1. Maternal Risk Factors and Perinatal Outcome of Fetal Growth Restriction.
This prospective single-center study of 140 pregnancies with FGR found that severe FGR (<5th percentile) accounted for 72.1% of cases. Maternal age >35 years was significantly associated with severe FGR, and hypertensive disorders were the most common maternal comorbidity; 30% of neonates required NICU care (median 4 days) with notable morbidities including prematurity, RDS, sepsis, MAS, and jaundice.
Impact: Provides context-specific, prospective data linking maternal age and hypertensive disorders to severe FGR and quantifies neonatal resource utilization and morbidity in a LMIC setting.
Clinical Implications: Prioritize antenatal surveillance for women aged >35 and those with hypertensive disorders, with proactive delivery planning and NICU preparedness for FGR pregnancies to mitigate neonatal complications.
Key Findings
- Severe FGR (<5th percentile) comprised 72.1% (101/140) of cases; mild FGR (<10th percentile) was 27.9% (39/140).
- Maternal age >35 years was a statistically significant risk factor for severe FGR.
- Hypertensive disorders of pregnancy were the most common maternal comorbidity, followed by heart disease and thyroid disorders.
- 30% (42/140) of FGR neonates required NICU admission with a median stay of 4 days; morbidities included prematurity, RDS, sepsis, MAS, and jaundice.
- Among 140 FGR infants, 138 were liveborn and 2 neonatal deaths occurred.
Methodological Strengths
- Prospective data collection with predefined inclusion criteria
- Use of binary logistic regression to assess associations between risk factors and severity
- Clear reporting of neonatal outcomes and NICU utilization
Limitations
- Single-center study with modest sample size (N=140)
- No non-FGR control group; limited adjustment for confounding beyond available comorbidities
- Lack of long-term neonatal follow-up and maternal outcome data
Future Directions: Conduct multicenter, adequately powered prospective cohorts with standardized definitions; evaluate targeted antenatal surveillance and timing-of-delivery strategies in high-risk groups; include long-term neurodevelopmental outcomes.