Introduction: Fetal growth restriction (FGR) is associated with increased risk for stillbirth, perinatal morbidity, cerebral palsy, neurodevelopmental disorders and cardiovascular disease later in life. Identifying small-for-gestational-age (SGA) fetuses is crucial for the diagnosis of FGR. The aim of this study was to investigate the association between antenatal identification of SGA fetuses and severe adverse perinatal and childhood outcome.
Material And Methods: A register-based cohort study of all newborns delivered in Stockholm in 2014 and 2017.
Inclusion Criteria: singleton pregnancies without chromosomal aberrations or structural abnormalities, with a gestational age at delivery between 22+0 and 43+0 (n = 48 843). Data from childbirth records were linked to data from nationwide Swedish registers. Pregnancy including offspring data were reviewed. Adverse outcomes for non-identified and identified SGA newborns were compared using logistic regression models. Primary outcome was a composite outcome called severe adverse outcome, defined as at least one of the following: stillbirth, severe newborn distress (Apgar score <4 at 5 min, pH <7 or resuscitation activities >10 min), severe neonatal outcome (hypoxic ischemic encephalopathy 2-3, necrotizing enterocolitis, neonatal seizures, intraventricular hemorrhage grade 3-4, bronchopulmonary disease or death at <1 year), severe childhood outcome (cognitive impairment or motor impairment or cerebral palsy or hearing impairment or visual impairment or death at 1-3 years old). Secondary outcomes were stillbirth, severe newborn distress, severe neonatal outcome, severe childhood outcome.
Results: No association was found between antenatal identification of SGA fetuses and severe adverse outcome using the complete composite outcome (adjusted odds ratio [aOR] 1.19, 95% confidence interval [CI] 0.93-1.53). In subgroup analyses, non-identified SGA fetuses had an almost fivefold increased risk for stillbirth (aOR 4.79, 95% CI 2.63-8.72) and an increased risk for severe newborn distress (aOR 1.36, 95% CI 1.02-1.82), but a decreased risk for severe childhood outcome (aOR 0.63, 95% CI 0.40-0.99). No association was found between antenatal identification of SGA and severe neonatal outcome.
Conclusions: Non-identified SGA fetuses have an increased risk for stillbirth and severe newborn distress. Conversely, identified SGA fetuses have an increased risk for severe childhood outcome.
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http://dx.doi.org/10.1111/aogs.14697 | DOI Listing |
Am J Obstet Gynecol
December 2024
department of Obstetrics and Gynaecology, University Medical Center Utrecht, Lundlaan 6, 3584 EA, Utrecht, and department of Obstetrics and Gynaecology, Erasmus Medical Center, Rotterdam, the Netherlands. Electronic address:
Background: Early-onset fetal growth restriction as consequence of placental insufficiency frequently requires iatrogenic, preterm birth. Administration of antenatal corticosteroids reduces risks of neonatal morbidity and mortality following preterm birth and is most beneficial if the neonate is delivered within two weeks following treatment. International guidelines on fetal growth restriction pregnancies do not provide directives regarding the timing of antenatal corticosteroids, resulting in practice variation.
View Article and Find Full Text PDFJ Gynecol Obstet Hum Reprod
December 2024
URP FETUS 7328, Federation for Research into Innovative Explorations and Therapeutics in Utero, and LUMIERE Platform, University of Paris Cité, Paris, France; Department of Obstetrics and Gynecology, Pitié-Salpêtrière Hospital, APHP, Sorbonne University, Paris, France. Electronic address:
S Afr Fam Pract (2004)
November 2024
Department of Obstetrics and Gynecology, College of Health Sciences, University of KwaZulu-Natal, Durban.
Background: Hypertensive disorders of pregnancy are major contributors to maternal mortality in South Africa. Preventative strategies in low- and middle-income countries emphasise frequent antenatal visits, symptom identification, patient education and the prophylactic use of calcium and low-dose aspirin to prevent HDP for nurses because they are the frontline workers at antenatal clinics countrywide.
Methods: This was a cross-sectional study where a self-administered questionnaire was conducted among nurses (midwives and professional nurses) employed at hospitals and clinics in Durban, South Africa, to assess their understanding and practices regarding identification and initial management of HDP, particularly for eclampsia and PE with severe features.
BMC Pediatr
November 2024
Division of Infectious Diseases, Department of Pediatrics, New York Presbyterian-Columbia University Irving Medical Center, 650 W 168TH St, New York, NY, 10032, USA.
Medicina (Kaunas)
November 2024
Kartal Koşuyolu High Specialization Training and Research Hospital, 63050 Istanbul, Turkey.
: Preeclampsia, a pregnancy-induced hypertensive disorder, shares cardiovascular characteristics in etiology, prognosis, and fetomaternal risks. Electrocardiography plays a pivotal role in assessing cardiovascular risks. Beyond conventional predictors, identifying easily obtainable and reproducible electrocardiographic markers may significantly contribute to the early identification of individuals at risk of preeclampsia.
View Article and Find Full Text PDFEnter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!