Pregestational risks of insufficient fetus growth
AbstractThe aim of the study – differentiated assessment of pregestational risk of fetal growth restriction (FGR) and pregestational risk of small for gestational age fetus (SGA).
Material and methods. A prospective cohort study was performed. The main clinical base was the perinatal center of the State Budgetary Institution of Health of the Republic of Crimea “Republican Clinical Hospital named after N.A. Semashko”. Study period: 2018–2020. The study included 611 women with singleton pregnancies with insufficient fetal growth. Two clinical groups were formed: women with FGR (n=435) and women with SGA (n=176).
Results. Women with FGR (fetal growth restriction) are distinguished from women with SGA (small for gestational age fetus) (p<0.05) by a greater association with living in the city and delivery by caesarean section (CS); an exclusive association with the lack of information or secondary specialized education, the type of work “working”, smoking, the history of assisted reproductive technologies (ART) or CS; higher values of maternal growth, the number of spontaneous miscarriages and artifactual abortions; lower values of such indicators as the age of the child’s father, mother’s weight, her pregestational BMI, age of menarche, number of pregnancies in history, time interval from previous pregnancy, number of births, time interval from previous births, gestational age at previous delivery, fetal weight in previous births. Women with SGA are statistically significantly different from women with FGR by a high level of association with permanence of the place of residence, experience of childbirth, natural childbirth, exceptional association with secondary education, employment in principle, type of work “employee”. The proposed models of differentiated FGR or MGW prediction based on the equations of the discriminant function have an accuracy of up to 100%.
Conclusion. Highly informative predictors of FGR or SGA are diverse, socio-demographic determinants of insufficient fetal growth compete in importance with reproductive ones. The risks of FGR and SGA are not identical. Mathematical prediction of FGR or SGA based on a combination of multi-temporal and diverse factors opens up prospects for personalized preconception preparation, and conducting diagnostic measures during dispensary observation for pregnancy, provide prerequisites for an early dialogue with the mother/father of the child about the “parental” risks of insufficient fetal growth, possible outcomes, and the possibilities of their modification or minimization.
Keywords:pregnancy; fetal growth restriction; small for gestational age
Funding. The study had no sponsor support.
Conflict of interest. The authors declare no conflict of interest.
For citation: Ziyadinov A.A., Novikova V.A. Pregestational risks of insufficient fetus growthAkusherstvo i ginekologiya: novosti, mneniya, obuchenie [Obstetrics and Gynecology: News, Opinions, Training]. 2023; 11 (3): 44–51. DOI: https://doi.org/10.33029/2303-9698-2023-11-3-44-51 (in Russian)
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