Reduced fetal growth velocity and weight loss are associated with adverse perinatal outcome in fetuses at risk of growth restriction.
Doppler
adverse outcome
brain sparing
catabolism
cerebral blood flow redistribution
cerebro-placental ratio
fetal growth restriction
growth velocity
hypoxemia
middle cerebral artery
small for gestational age
umbilical-cerebral ratio
Journal
American journal of obstetrics and gynecology
ISSN: 1097-6868
Titre abrégé: Am J Obstet Gynecol
Pays: United States
ID NLM: 0370476
Informations de publication
Date de publication:
01 2023
01 2023
Historique:
received:
21
02
2022
revised:
15
06
2022
accepted:
16
06
2022
pubmed:
26
6
2022
medline:
28
12
2022
entrez:
25
6
2022
Statut:
ppublish
Résumé
Although fetal size is associated with adverse perinatal outcome, the relationship between fetal growth velocity and adverse perinatal outcome is unclear. This study aimed to evaluate the relationship between fetal growth velocity and signs of cerebral blood flow redistribution, and their association with birthweight and adverse perinatal outcome. This study was a secondary analysis of the TRUFFLE-2 multicenter observational prospective feasibility study of fetuses at risk of fetal growth restriction between 32 Adverse perinatal outcome was more frequent among fetuses whose antenatal growth was <100 g/wk, irrespective of signs of cerebral blood flow redistribution. Infants with birthweight <0.65 multiple of the median were enrolled earlier, had the lowest fetal growth velocity, higher umbilical-cerebral ratio, and were more likely to have adverse perinatal outcome. A decreasing fetal growth velocity was observed in 163 (19%) women in whom the estimated fetal weight multiple of the median regression coefficient was <-0.025, and who had higher umbilical-cerebral ratio values and more frequent adverse perinatal outcome; 67 (41%; 8% of total group) of these women had negative growth velocity. Estimated fetal weight and umbilical-cerebral ratio at admission and fetal growth velocity combined by logistic regression had a higher association with adverse perinatal outcome than any of those parameters separately (relative risk, 3.3; 95% confidence interval, 2.3-4.8). In fetuses at risk of late preterm fetal growth restriction, reduced growth velocity is associated with an increased risk of adverse perinatal outcome, irrespective of signs of cerebral blood flow redistribution. Some fetuses showed negative growth velocity, suggesting catabolic metabolism.
Sections du résumé
BACKGROUND
Although fetal size is associated with adverse perinatal outcome, the relationship between fetal growth velocity and adverse perinatal outcome is unclear.
OBJECTIVE
This study aimed to evaluate the relationship between fetal growth velocity and signs of cerebral blood flow redistribution, and their association with birthweight and adverse perinatal outcome.
STUDY DESIGN
This study was a secondary analysis of the TRUFFLE-2 multicenter observational prospective feasibility study of fetuses at risk of fetal growth restriction between 32
RESULTS
Adverse perinatal outcome was more frequent among fetuses whose antenatal growth was <100 g/wk, irrespective of signs of cerebral blood flow redistribution. Infants with birthweight <0.65 multiple of the median were enrolled earlier, had the lowest fetal growth velocity, higher umbilical-cerebral ratio, and were more likely to have adverse perinatal outcome. A decreasing fetal growth velocity was observed in 163 (19%) women in whom the estimated fetal weight multiple of the median regression coefficient was <-0.025, and who had higher umbilical-cerebral ratio values and more frequent adverse perinatal outcome; 67 (41%; 8% of total group) of these women had negative growth velocity. Estimated fetal weight and umbilical-cerebral ratio at admission and fetal growth velocity combined by logistic regression had a higher association with adverse perinatal outcome than any of those parameters separately (relative risk, 3.3; 95% confidence interval, 2.3-4.8).
CONCLUSION
In fetuses at risk of late preterm fetal growth restriction, reduced growth velocity is associated with an increased risk of adverse perinatal outcome, irrespective of signs of cerebral blood flow redistribution. Some fetuses showed negative growth velocity, suggesting catabolic metabolism.
Identifiants
pubmed: 35752304
pii: S0002-9378(22)00477-X
doi: 10.1016/j.ajog.2022.06.023
pii:
doi:
Types de publication
Observational Study
Multicenter Study
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
71.e1-71.e10Investigateurs
Bine Arabin
(B)
Astrid Berger
(A)
Eva Bergman
(E)
Amarnath Bhide
(A)
Caterina M Bilardo
(CM)
Andrew C Breeze
(AC)
Jana Brodszki
(J)
Pavel Calda
(P)
Elena Cesari
(E)
Irene Cetin
(I)
Jan B Derks
(JB)
Catherine Ebbing
(C)
Enrico Ferrazzi
(E)
Tiziana Frusca
(T)
Wessel Ganzevoort
(W)
Sanne J Gordijn
(SJ)
Wilfried Gyselaers
(W)
Kurt Hecher
(K)
Philipp Klaritsch
(P)
Ladislav Krofta
(L)
Peter Lindgren
(P)
Silvia M Lobmaier
(SM)
Gisuseppe M Maruotti
(GM)
Federico Mecacci
(F)
Kirsti Myklestad
(K)
Rafaele Napolitano
(R)
Federico Prefumo
(F)
Luigi Raio
(L)
Jute Richter
(J)
Ragnar K Sande
(RK)
Jim Thornton
(J)
Herbert Valensise
(H)
Gerry H A Visser
(GHA)
Ling Wee
(L)
Informations de copyright
Copyright © 2022 The Authors. Published by Elsevier Inc. All rights reserved.