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Am J Perinatol 2024; 41(S 01): e1470-e1477
DOI: 10.1055/a-2051-3859
Original Article

Outcomes among Neonates after a Diagnosis of Persistent or Transient Fetal Growth Restriction Delivered at Term

Sebastian Z. Ramos 
1   Department of Obstetrics and Gynecology, Women & Infants Hospital, The Warren Alpert Medical School of Brown University, Providence, Rhode Island
,
Phinnara Has
2   Lifespan Biostatistics, Epidemiology, and Research Design (BERD), Rhode Island Hospital, Lifespan Healthcare System, Providence, Rhode Island
,
Alexis C. Gimovsky 
1   Department of Obstetrics and Gynecology, Women & Infants Hospital, The Warren Alpert Medical School of Brown University, Providence, Rhode Island
,
Valery A. Danilack 
3   Center for Outcomes Research and Evaluation, Yale University School of Medicine, New Haven, Connecticut
,
David A. Savitz
1   Department of Obstetrics and Gynecology, Women & Infants Hospital, The Warren Alpert Medical School of Brown University, Providence, Rhode Island
4   Department of Epidemiology, Brown University School of Public Health, Providence, Rhode Island
,
Adam K. Lewkowitz
1   Department of Obstetrics and Gynecology, Women & Infants Hospital, The Warren Alpert Medical School of Brown University, Providence, Rhode Island
› Author Affiliations
Funding This study was supported by the National Institutes of Health (NIH) “Effect of Iatrogenic Delivery at 34-38 Weeks' Gestation on Pregnancy Outcome” (grant no.: 1R01HD077592; PI: D.A.S.). This work was also supported by the NIH/Office of Research on Women's Health Building Interdisciplinary Research Careers in Women's Health (grant no.: 5K12HD092535) scholar funds to S.Z.R. Dr. Ramos was supported by the NIH/Office of Research on Women's Health Building Interdisciplinary Research Careers in Women's Health (Grant number: 5K12HD092535). The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIH.
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Corrigendum: Outcomes among Neonates after a Diagnosis of Persistent or Transient Fetal Growth Restriction Delivered at TermAm J Perinatol 2024; 41(S 01): e1478-e1478
DOI: 10.1055/s-0044-1786526

Abstract

Objective 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.

Study Design 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.

Results 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.

Conclusion 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.

Key Points

  • 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.

Keywords

fetal growth restriction - antepartum surveillance - neonatal outcomes - small for gestational age - composite neonatal morbidity

Note

This abstract was presented at the 41st Annual Pregnancy Meeting of the Society for Maternal-Fetal Medicine virtually on January 25 to 30, 2021, and received the Best Poster Award for its session.


Supplementary Material



Publication History

Received: 06 June 2022

Accepted: 24 February 2023

Accepted Manuscript online:
09 March 2023

Article published online:
10 April 2023

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