Reduced fetal growth velocity and weight loss are associated with adverse perinatal outcome in fetuses at risk of growth restriction

Stampalija, Tamara; Wolf, Hans; Mylrea‐Foley, Bronacha; Marlow, Neil; Stephens, Katie; Shaw, Caroline J.; Lees, C.

doi:10.1016/j.ajog.2022.06.023

Cited by 16 publications

(13 citation statements)

References 38 publications

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“…Unidentified SGA in this context can be explained by late‐onset growth restriction, overestimated fetal weight, loss of fetal weight or a combination of these. Overestimated fetal weight has been reported previously in a meta‐analysis 32 , and fetal weight loss has been hypothesized in single‐ and multicenter cohort studies, which reported similar rates of SGA detection to those reported here 33,34 .…”

Section: Discussionsupporting

confidence: 81%

Characteristics associated with antenatally unidentified small‐for‐gestational‐age fetuses: prospective cohort study nested within DESiGN randomized controlled trial

Relph

Vieira

Copas

et al. 2023

Ultrasound in Obstet & Gyne

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What are the novel findings of this work?Pregnancies with unidentified small-for-gestational-age (SGA) fetuses were less likely to have an indication for serial scan and more likely to have a body mass index of 25.0-29.9 kg/m 2 , less severe SGA and cephalic presentation at birth. Two-thirds of SGA pregnancies had no serial scan indication, which emphasizes the importance of an accurate screening strategy for low-risk women. What are the clinical implications of this work?Unidentified SGA is more likely in overweight women and those without a serial scan indication. Missed-case analysis is important to investigate unidentified SGA amongst women with risk factors but no serial scans. Further research should determine how to improve SGA detection for women who are overweight or low risk.

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Section: Discussionsupporting

confidence: 81%

Characteristics associated with antenatally unidentified small‐for‐gestational‐age fetuses: prospective cohort study nested within DESiGN randomized controlled trial

Relph

Vieira

Copas

et al. 2023

Ultrasound in Obstet & Gyne

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“…56 It is still not known what kind of implication the exposition to varying degrees of oxygen and nutrient deprivation may have on the fetus and its growth velocity, but the latter has been shown to be associated with adverse perinatal outcome even in the absence of Doppler abnormalities. 57 If further studies confirm umbilical vein blood flow to be associated with adverse fetal and neonatal outcomes, 58 this information might be combined with other Doppler and biophysical indices for risk stratification assessment.…”

Section: Fetal Macrosomiamentioning

confidence: 99%

“…A possible explanation might be that, due to lower umbilical vein blood flow, there is a lower nutrient and oxygen delivery that may lead to decreased fetal energy reserves, and as such to require complementary feeding in the immediate post‐natal life 56 . It is still not known what kind of implication the exposition to varying degrees of oxygen and nutrient deprivation may have on the fetus and its growth velocity, but the latter has been shown to be associated with adverse perinatal outcome even in the absence of Doppler abnormalities 57 . If further studies confirm umbilical vein blood flow to be associated with adverse fetal and neonatal outcomes, 58 this information might be combined with other Doppler and biophysical indices for risk stratification assessment.…”

Section: Introductionmentioning

confidence: 99%

Umbilical vein blood flow: State‐of‐the‐art

Barbieri

Martino

Ferrazzi

et al. 2023

J of Clinical Ultrasound

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Placental blood supply to the fetus can be measured by evaluating the umbilical vein blood flow. Despite its potential application in healthcare, the umbilical vein blood flow volume is still used only in research setting. One of the reasons is a concern regarding its reproducibility, partly due to technology issues. Nowadays, technology improvements make this evaluation accurate and reproducible. The aim of this review is to refresh basic elements of the physiology of umbilical vein blood flow and its analysis. Its evaluation in normal and abnormal fetal growth is also discussed.

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“…Indeed, recent evidence shows a significant correlation with indicators of placental dysfunction, even in those fetuses considered adequate for gestational age (GA) [32][33][34][35], including an independent association with perinatal mortality [36]. Moreover, its use during the second half of pregnancy improves the characterization of fetuses at higher risk [37][38][39][40][41][42].…”

Section: Introductionmentioning

confidence: 99%

Fetal Growth Velocity according to the Mode of Assisted Conception

Bull¹,

Ávila²,

Vargas³

et al. 2023

Fetal Diagn Ther

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Introduction: Pregnancies conceived through assisted reproductive techniques (ARTs) are on the rise worldwide and have been associated with a higher risk of placental-related disease in the third trimester. Methods: A cohort was created of singleton pregnancies after assisted reproduction, admitted at our institution for delivery, between January 2020 and August 2022. Fetal growth velocity from the second trimester to delivery was compared against a gestational-age-matched group of pregnancies spontaneously conceived according to the origin of the selected oocyte (i.e., autologous vs. donated). Results: 125 singleton pregnancies conceived through ART were compared to 315 singleton spontaneous conceptions. Overall, after adjusting for possible confounders, multivariate analysis demonstrated that ART pregnancies had a significantly lower estimated fetal weight (EFW) z-velocity from the second trimester to delivery (adjusted mean difference = −0.002; p = 0.035) and a higher frequency of EFW z-velocity in the lowest decile (adjusted OR = 2.32 [95% CI, 1.15–4.68]). Also, when ART pregnancies were compared according to the type of oocyte, those conceived with donated oocytes showed a significantly lower EFW z-velocity from the second trimester to delivery (adjusted mean difference = −0.008; p = 0.001) and a higher frequency of EFW z-velocity in the lowest decile (adjusted OR = 5.33 [95% CI, 1.34–21.5]). Conclusions: Pregnancies achieved through ART exhibit a pattern of lower growth velocity across the third trimester, especially those conceived with donated oocytes. The former represents a sub-group at the highest risk of placental dysfunction that may warrant closer follow-up.

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Reduced fetal growth velocity and weight loss are associated with adverse perinatal outcome in fetuses at risk of growth restriction

Cited by 16 publications

References 38 publications

Characteristics associated with antenatally unidentified small‐for‐gestational‐age fetuses: prospective cohort study nested within DESiGN randomized controlled trial

Characteristics associated with antenatally unidentified small‐for‐gestational‐age fetuses: prospective cohort study nested within DESiGN randomized controlled trial

Umbilical vein blood flow: State‐of‐the‐art

Fetal Growth Velocity according to the Mode of Assisted Conception

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