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Obstetric and pediatric growth charts for the detection of late-onset fetal growth restriction and neonatal adverse outcomes

  • Beatriz Fernandez-Rodriguez EMAIL logo , Concepción de Alba , Alberto Galindo , David Recio , Cecilia Villalain , Carmen Rosa Pallas and Ignacio Herraiz
Published/Copyright: October 7, 2020
Journal of Perinatal Medicine
From the journal Journal of Perinatal Medicine Volume 49 Issue 2

Abstract

Objectives

Late-onset fetal growth restriction (FGR) has heterogeneous prenatal and postnatal diagnostic criteria. We compared the prenatal and postnatal diagnosis of late-onset FGR and their ability to predict adverse perinatal outcomes.

Methods

Retrospective cohort study of 5442 consecutive singleton pregnancies that delivered beyond 34 + 0 weeks. Prenatal diagnosis of FGR was based on customized fetal growth standards and fetal Doppler while postnatal diagnosis was based on a birthweight <3rd percentile according to newborn charts (Olsen’s charts and Intergrowth 21st century programme). Perinatal outcomes were analyzed depending on whether the diagnosis was prenatal, postnatal or both.

Results

A total of 94 out of 5442 (1.7%) were diagnosed as late-onset FGR prenatally. Olsen’s chart and Intergrowth 21st chart detected that 125/5442 (2.3%) and 106/5442 (2.0%) of infants had a birthweight <3rd percentile, respectively. These charts identified 35/94 (37.2%) and 40/94 (42.6%) of the newborns with a prenatal diagnosis of late-onset FGR. Prenatally diagnosed late-onset FGR infants were at a higher risk for hypoglycemia, jaundice and polycythemia. Both prenatally and postnatally diagnosed as late-onset FGR had a higher risk for respiratory distress syndrome when compared to non-FGR. The higher risks for intensive care admission and composite adverse outcomes were observed in those with a prenatal diagnosis of late-onset FGR that was confirmed after birth.

Conclusions

Current definitions of pre- and postnatal late-onset FGR do not match in more than half of cases. Infants with a prenatal or postnatal diagnosis of this condition have an increased risk of neonatal morbidity even if these diagnoses are not coincident.

Keywords: growth charts; late-onset fetal growth restriction; perinatal outcome; placental dysfunction
Corresponding author: Beatriz Fernández Rodriguez, Department of Pediatrics, Hospital Universitario del Tajo, Avenida del Amazonas Central S/N, 28300, Aranjuez, Madrid, Spain, E-mail:

  1. Research funding: None declared.

  2. Author contributions: All authors have accepted responsibility for the entire content of this manuscript and approved its submission.

  3. Competing interests: Authors state no conflict of interest.

  4. Informed consent: Due to the retrospective design of the study and the data anonymization it was unnecessary to have a signed informed consent from the patients.

  5. Ethical approval: The local Ethics Committee approved the study (PI13/02405).

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Supplementary Material

The online version of this article offers supplementary material (https://doi.org/10.1515/jpm-2020-0210).

Received: 2020-05-14
Accepted: 2020-09-11
Published Online: 2020-10-07
Published in Print: 2021-02-23

© 2020 Walter de Gruyter GmbH, Berlin/Boston

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  17. Original Articles – Fetus
  18. CD34 immunostain increases sensitivity of the diagnosis of fetal vascular malperfusion in placentas from ex-utero intrapartum treatment
  19. The ability of various cerebroplacental ratio thresholds to predict adverse neonatal outcomes in term fetuses exhibiting late-onset fetal growth restriction
  20. Obstetric and pediatric growth charts for the detection of late-onset fetal growth restriction and neonatal adverse outcomes
  21. Original Articles – Neonates
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https://doi.org/10.1515/jpm-2020-0210
Keywords for this article
growth charts; late-onset fetal growth restriction; perinatal outcome; placental dysfunction

Articles in the same Issue

  1. Frontmatter
  2. Review
  3. Methods of detection and prevention of preterm labour and the PAMG-1 detection test: a review
  4. Corner of Academy
  5. Long term alterations of growth after antenatal steroids in preterm twin pregnancies
  6. Original Articles – Obstetrics
  7. SARS-CoV-2 in pregnancy: maternal and perinatal outcome data of 34 pregnant women hospitalised between May and October 2020
  8. Comparison of hematological parameters and perinatal outcomes between COVID-19 pregnancies and healthy pregnancy cohort
  9. The effect of mask use on maternal oxygen saturation in term pregnancies during the COVID-19 process
  10. Risk factors for pregnancy-associated venous thromboembolism in Singapore
  11. Does the length of second stage of labour or second stage caesarean section in nulliparous women increase the risk of preterm birth in subsequent pregnancies?
  12. Reference range for C1-esterase inhibitor (C1 INH) in the third trimester of pregnancy
  13. Termination of pregnancy following a Down Syndrome diagnosis: decision-making process and influential factors in a Muslim but secular country, Turkey
  14. High dose vs. low dose oxytocin for labor augmentation: a systematic review and meta-analysis of randomized controlled trials
  15. Extremely high levels of alkaline phosphatase and pregnancy outcome: case series and review of the literature
  16. Cervical elastography strain ratio and strain pattern for the prediction of a successful induction of labour
  17. Original Articles – Fetus
  18. CD34 immunostain increases sensitivity of the diagnosis of fetal vascular malperfusion in placentas from ex-utero intrapartum treatment
  19. The ability of various cerebroplacental ratio thresholds to predict adverse neonatal outcomes in term fetuses exhibiting late-onset fetal growth restriction
  20. Obstetric and pediatric growth charts for the detection of late-onset fetal growth restriction and neonatal adverse outcomes
  21. Original Articles – Neonates
  22. Bacterial stability with freezer storage of human milk
  23. Protein and genetic expression of CDKN1C and IGF2 and clinical features related to human umbilical cord length
  24. Short Communication
  25. A considerable asymptomatic proportion and thromboembolism risk of pregnant women with COVID-19 infection in Wuhan, China
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