Are perinatal and maternal outcomes different during expectant management of severe preeclampsia in the presence of intrauterine growth restriction?

Objective: The purpose of this study was to compare perinatal and maternal outcomes in women with singleton pregnancies and severe preeclampsia (SPE) expectantly managed at 24-33 weeks' gestation (wk) that resulted at birth in severe intrauterine growth restriction (SIUGR, < 5th percentile) to those without SIUGR.

Study Design: Two hundred thirty-nine women undelivered after antenatal steroids were expectantly managed. Perinatal and maternal outcomes were analyzed according to fetal growth status. Students t-test, chi-square test, logistic regression analysis, and odds ratio were calculated.

Results: Fifty-eight pregnancies resulted in an SIUGR neonate. Median latency periods (5 vs 5 d) and delivery gestational ages (30.6 vs 30.3 wk) were similar in the 2 groups. Controlling for gestational age at delivery, only fetal death remained associated with SIUGR (OR: 6.4; 95% CI 1.05-39.35, P = .04). Maternal outcomes were similar in the 2 groups.

Conclusion: In severe preeclamptic women at 24-33 weeks, SIUGR is associated with increased risk of fetal death but does not affect maternal complications.