Detection rate of prenatal fetal growth restriction

• Main Authors: Ksenija Geršak, Ismaili Hatije, Gorazd Kavšek
• Format: Article
• Language: English
• Published: Slovenian Medical Association 2010-10-01
• Series: Zdravniški Vestnik
• Online Access: http://vestnik.szd.si/index.php/ZdravVest/article/view/309

Background: Fatal growth restriction (FGR) is associated with significant increases in morbidity and mortality in the perinatal period and also in infancy and in adulthood. The aim of the retrospective study was to establish the detection rate for FGR using routine screening methods and to define the risk factors for FGR in our population. Methods: All women who delivered term singletons with birth weight below 10th centile for the gestation age between May 1, 2008 and December 31, 2008 at the Department of Obstetrics and Gynaecology in Ljubljana were included. The data have been collected from individual maternal records and from newborns’ forms. According to FGR estimation during pregnancy and small for gestational age at birth (SGA), women were divided into four groups. Results: At birth, 381 (8 %) newborns had a birth weight below the 10th centile for the gestational age; 22 % of infants (87/381) were defined as small for gestational age without FGR detected during pregnancy; among those with suspected FGR 11.3 % of infants (43/381) were born with normal birth weight and 20.2 % (78/381) as SGA; 45 % of newborns (173/381) without FGR detected during pregnancy were defined as normal weight by neonatologists. According to neonatologist’s evaluation 43.3 % infants (165/381) were defined as SGA. FGR was recognized during pregnancy only in 47 % of cases (78/165), and 56 % of newborns (216/381) with birth weight below the 10th centile for the gestational age were not identified as SGA. Among risk factors, assisted reproduction (OR 12.4, 95 % CI 1.55–18.92) was positively associated with FGR. When FGR was suspected, significantly more sonographic examinations were performed. If biometric parameters or estimated foetal weight were regularly reported in individual maternal records, more FGR were detected during pregnancy. Symphysis-fundal height measurement was used in less than 30 % of cases. Conclusions: Less than 50 % of FGR pregnancies were detected. The detection rate can be improved using routine methods to screen all pregnancies for FGR and to prepare Slovene reference standards for biometric parameters and estimated foetal weight during pregnancy for given gestational age.