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.
BACKGROUND: Worldwide, Fetal growth restriction is a leading cause of stillbirth, neonatal mortality, and morbidity. Several maternal factors influence fetal growth and increases the risk of fetal growth restriction. Our study aimed to determine the risk factors and perinatal outcome of fetal growth restriction at Tribhuvan University teaching hospital, Maharajgunj, Kathmandu. METHODS: A prospective study was conducted in the department of Obstetrics and Gynecology at Tribhuvan University teaching hospital. A total of 140 Pregnant women at > 28 weeks period of gestation clinically diagnosed as FGR and fulfilling the inclusion criteria were enrolled in this study. The data was analyzed using SPSS 23. The association between various risk factors and FGR was studied using the binary logistic regression. RESULTS: Among the 140 FGR fetuses, 27.9 % (39) belonged to the <10th percentile (Mild Fetal growth restriction) and 72.1%(101) belonged to<5th percentile (Severe Fetal growth restriction). Maternal age more than 35 years was found to be statistically significant as a risk factor in the severe Fetal growth restriction group. Among the maternal co-morbidities, hypertensive disorder of pregnancy was found to be the most common co-morbidity followed by heart disease and thyroid disorders. The Fetal growth restriction neonates requiring neonatal intensive care unit (NICU) stay was 42 (30%) and the median neonatal intensive care unit stay was 4 days. The fetal morbidities associated with fetal growth restriction were prematurity,respiratory distress syndrome(RDS), sepsis, meconium aspiration syndrome(MAS) and neonatal jaundice (NNJ). Among the 140 FGR babies, 138 were live born and there were 2 neonatal deaths (NND). CONCLUSIONS: In our study ,advanced maternal age is found to be a significant risk factor for Fetal growth restriction and gestational hypertension is the most common comorbidity associated with Fetal growth restriction. Therefore, identification of such women, their regular antenatal checkups, fetal surveillance and timely intervention are crucial for better perinatal outcome.