Outcomes among Neonates after a Diagnosis of Persistent or Transient Fetal Growth Restriction Delivered at Term.
Journal
American journal of perinatology
ISSN: 1098-8785
Titre abrégé: Am J Perinatol
Pays: United States
ID NLM: 8405212
Informations de publication
Date de publication:
10 Apr 2023
10 Apr 2023
Historique:
pmc-release:
10
10
2024
pubmed:
10
3
2023
medline:
10
3
2023
entrez:
9
3
2023
Statut:
aheadofprint
Résumé
This study aimed to evaluate whether transient fetal growth restriction (FGR) that resolves prior to delivery confers a similar risk of neonatal morbidity as uncomplicated FGR that persists at term. This is a secondary analysis of a medical record abstraction study of singleton live-born pregnancies delivered at a tertiary care center between 2002 and 2013. Patients with fetuses that had either persistent or transient FGR and delivered at 38 weeks or later were included. Patients with abnormal umbilical artery Doppler studies were excluded. Persistent FGR was defined as estimated fetal weight (EFW) <10th percentile by gestational age from diagnosis through delivery. Transient FGR was defined as EFW <10th percentile on at least one ultrasound, but not on the last ultrasound prior to delivery. The primary outcome was a composite of neonatal morbidity: neonatal intensive care unit admission, Apgar's score <7 at 5 minutes, neonatal resuscitation, arterial cord pH <7.1, respiratory distress syndrome, transient tachypnea of the newborn, hypoglycemia, sepsis, or death. Baseline characteristics and obstetric and neonatal outcomes were compared using Wilcoxon's rank-sum and Fisher's exact test. Log binomial regression was used to adjust for confounders. Of 777 patients studied, 686 (88%) had persistent FGR and 91 (12%) had transient FGR. Patients with transient FGR were more likely to have a higher body mass index, gestational diabetes, diagnosed with FGR earlier in pregnancy, have spontaneous labor, and deliver at later gestational ages. There was no difference in the composite neonatal outcome (relative risk = 1.03, 95% confidence interval [CI] 0.72, 1.47) for transient versus persistent FGR after adjusting for confounders (adjusted relative risk = 0.79, 95% CI 0.54, 1.17). There were no differences in cesarean delivery or delivery complications between groups. Neonates born at term after transient FGR do not appear to have differences in composite morbidity compared with those where uncomplicated FGR persists at term. · No differences in neonatal outcomes in uncomplicated persistent versus transient FGR at term.. · Transient FGR pregnancies more likely to deliver at later gestational ages.. · No differences in mode of delivery or obstetric complications in persistent versus transient FGR at term..
Identifiants
pubmed: 36894159
doi: 10.1055/a-2051-3859
pmc: PMC10562520
mid: NIHMS1908090
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Subventions
Organisme : NICHD NIH HHS
ID : R01 HD077592
Pays : United States
Informations de copyright
Thieme. All rights reserved.
Déclaration de conflit d'intérêts
None declared.
Références
J Matern Fetal Neonatal Med. 2020 Sep;33(18):3056-3061
pubmed: 30621506
BMC Pregnancy Childbirth. 2019 Jan 15;19(1):31
pubmed: 30646865
Am J Obstet Gynecol. 2020 Oct;223(4):B2-B17
pubmed: 32407785
Obstet Gynecol. 1995 Jul;86(1):102-7
pubmed: 7784001
Am J Perinatol. 2017 Mar;34(4):323-332
pubmed: 27533102
Int J Popul Data Sci. 2020 Aug 12;5(1):1337
pubmed: 33644407
Int J Mol Sci. 2014 Sep 12;15(9):16153-85
pubmed: 25222554
Obstet Gynecol. 2021 Feb 1;137(2):e29-e33
pubmed: 33481529
JAMA. 2000 Feb 2;283(5):625-32
pubmed: 10665702
Aust N Z J Obstet Gynaecol. 2014 Aug;54(4):354-9
pubmed: 24731210
Obstet Gynecol. 2019 Feb;133(2):e97-e109
pubmed: 30681542
Ultrasound Obstet Gynecol. 2019 Jun;53(6):715-723
pubmed: 31169958
Am J Obstet Gynecol. 2018 Feb;218(2S):S855-S868
pubmed: 29422214
Ultrasound Obstet Gynecol. 2008 Jul;32(1):61-5
pubmed: 18435526
Am J Obstet Gynecol. 2018 May;218(5):525.e1-525.e9
pubmed: 29462628
Am J Obstet Gynecol. 2003 Jun;188(6):1596-9; discussion 1599-601
pubmed: 12824998
Radiology. 1991 Oct;181(1):129-33
pubmed: 1887021
Obstet Gynecol. 2007 Nov;110(5):1151-64
pubmed: 17978132
J Intensive Care Med. 2004 Nov-Dec;19(6):307-19
pubmed: 15523117
Am J Obstet Gynecol. 2000 Jan;182(1 Pt 1):198-206
pubmed: 10649179
Obstet Gynecol. 2001 Apr;97(4):499-504
pubmed: 11275017
BMC Pregnancy Childbirth. 2014 Feb 11;14:63
pubmed: 24517273
Paediatr Perinat Epidemiol. 2018 May;32(3):268-280
pubmed: 29691880