Antenatal detection of fetal growth restriction and risk of stillbirth: population-based case-control study.
Adult
Birth Weight
Case-Control Studies
Female
Fetal Growth Retardation
/ diagnosis
Fetal Weight
Gestational Age
Humans
Infant, Newborn
Infant, Small for Gestational Age
Pregnancy
Prenatal Diagnosis
/ methods
Risk Assessment
/ methods
Stillbirth
/ epidemiology
Ultrasonography, Doppler
Ultrasonography, Prenatal
/ methods
Umbilical Arteries
/ diagnostic imaging
antenatal detection
fetal growth restriction
stillbirth
Journal
Ultrasound in obstetrics & gynecology : the official journal of the International Society of Ultrasound in Obstetrics and Gynecology
ISSN: 1469-0705
Titre abrégé: Ultrasound Obstet Gynecol
Pays: England
ID NLM: 9108340
Informations de publication
Date de publication:
05 2020
05 2020
Historique:
received:
15
02
2019
revised:
28
05
2019
accepted:
18
07
2019
pubmed:
1
8
2019
medline:
27
11
2021
entrez:
1
8
2019
Statut:
ppublish
Résumé
Antenatal surveillance of intrauterine growth aims to detect growth-restricted fetuses (FGR), which face increased risk of stillbirth. Improving their detection could be an effective strategy for prevention of stillbirth. The French REPERE study was conducted to estimate the association between antenatal detection of FGR and risk of stillbirth. REPERE is a case-control study performed in three French districts with a combined total of approximately 30 000 births annually. Cases were singleton small-for-gestational-age (SGA) stillbirths ≥ 24 weeks' gestation and without severe congenital anomaly, between 2012 and 2014, identified using a population-based stillbirth registry; controls were live births fulfilling the same inclusion criteria over a 9-week period from 7 April to 8 June 2014. Data were extracted by trained investigators from medical records and ultrasound reports. SGA was defined as birth weight < 10 During the study period, there were 92 182 births ≥ 22 weeks' gestation, including 669 stillbirths, of which 79 were singleton SGA stillbirths ≥ 24 weeks and without severe congenital anomaly. Of these cases, 44.3% (35/79) had FGR detected, compared with a detection rate of 36.2% in controls (154/426). The crude OR expressing the association between detection of FGR and risk of stillbirth was 1.4 (95% CI, 0.9-2.3) and the OR adjusted for parity, presence of risk factors for FGR, presence of vascular disorder and birth-weight percentile was 0.6 (95% CI, 0.3-1.0). Among deliveries ≥ 28 weeks, detection rates were 38.3% vs 36.0% for cases and controls, with an adjusted OR of 0.5 (95% CI, 0.2-1.0). Antenatal detection of FGR was protective against stillbirth, but over 40% of stillbirths among SGA fetuses occurred despite detection of FGR, pointing to the need to improve management following detection. Copyright © 2019 ISUOG. Published by John Wiley & Sons Ltd.
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
613-620Informations de copyright
Copyright © 2019 ISUOG. Published by John Wiley & Sons Ltd.
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