Abbreviations: aOR, adjusted odds ratio; AUC, area under the curve; CI, confidence interval; DV, ductus venosus; DV-FVW, ductus venosus flow velocity waveform; FGR, fetal growth restriction; MoM, multiples of the median; MPI, myocardial performance index; NND, neonatal death; NNM, neonatal morbidity; PIV, pulsatility index for veins; SE, standard error; UA, umbilical artery; UA-AEDF, umbilical artery absent end-diastolic flow; UA-REDF, umbilical artery reverse end-diastolic flow. Abstract Introduction: We aimed to assess if maximum velocities of the ductus venosus flow velocity waveform are associated with adverse outcomes in early-onset fetal growth restriction. Material and methods: Retrospective cohort study from two tertiary referral units, including singleton fetuses with estimated birthweight or fetal abdominal circumference ≤10th centile and absent or reversed end-diastolic velocity in the umbilical artery delivered between 26 +0 and 34 +0 weeks of gestation. Pulsatility index for veins, and maximum velocities of S-, D-, v-and a-waves, were measured in the ductus venosus within 24 hours of birth. Logistic regression was used to describe the relation between severe neonatal morbidity or neonatal death and clinical independent predictors. Results:The study population included 132 early-onset fetal growth restriction fetuses. Newborns with neonatal morbidity or neonatal death had significantly lower values of v/D maximum velocity ratio multiples of the median (0.86 vs 095; P = 0.006) within 24 hours of birth. The v/D ratio remained a significant predictor of neonatal death or severe neonatal morbidity after adjusting for gestational age and birthweight (adjusted odds ratio 0.065, 95% confidence interval 0.004-0.957). Conclusions: Assessment of ductus venosus v/D maximum velocity ratio might helpto identify fetal growth restriction fetuses at increased risk for neonatal death or severe neonatal morbidity. Confirmation in prospective studies is necessary. K E Y W O R D Scardiac dysfunction, Doppler ultrasound, ductus venosus, fetal growth restriction, intrauterine growth restriction, maximum velocities

Short oral presentation abstractsObjectives: To describe the outcome of growth-restricted fetuses with absent or reversed end-diastolic flow (ARED) in the umbilical artery delivered before 30 gestational weeks (GW). Methods: A retrospective study of all growth-restricted fetuses (singletons and twins with birth weight < mean -2SD) with ARED flow delivered in Lund during the time period of 1998-2015 (n=139). Control group: all AGA fetuses delivered < 30 GW during the corresponding time period (n=946). Perinatal mortality, neonatal morbidity, infant mortality and survival without neurodevelopmental impairment (NDI; cerebral palsy, cognitive delay, severe hearing impairment, blindness) after 2 years of age were compared between the two groups. Results: In the ARED group there were 7 cases of intrauterine death, all before 26 GW. The mean gestational age at birth was 26 GW in both groups, (range 23+3-29+6 and 22+0-29+6, respectively). There was no significant difference in perinatal mortality between the two groups (12% vs 15%). The incidence of chronic lung disease was higher in the ARED group than in control group (p < 0.001). There were no differences between the groups in the occurrence of necrotising enterocolitis, retinopathy of prematurity, intraventricular hemorrhage or cerebral palsy. The mean two-year survival was 83% in both group (ns). Significantly more children from the ARED group were in need of habilitation services (p < 0.01). Survival without NDI was 62% in the ARED group and 83% in the control group (p < 0.001); for children born after 26 GW the corresponding figures were 72% and 88% (p = 0.001). Conclusions: Very preterm growth-restricted fetuses with umbilical artery ARED flow delivered on fetal indication showed a high 2-year survival, similar rate of cerebral palsy and higher need for habilitation services compared to non-IUGR very preterm infants. OP16.04Effect of metformin in addition to an antenatal diet and lifestyle intervention on fetal growth and adiposity: the GRoW randomised trial