Factors of risk and perinatal outcomes in fetal growth restriction
Authors:   Ivanovo Scientific-Research Institute named after V.N. Gorodkov, Rokotyanskaya E.A. ,   Ivanovo, Russian Federation, Bichagova T.V. ,   Ivanovo Scientific-Research Institute named after V.N. Gorodkov; Ivanovo, Russian Federation, Shilova N.A. ,   Ivanovo Scientific-Research Institute named after V.N. Gorodkov; Ivanovo, Russian Federation, Salakhova L.M. ,   Ivanovo Scientific-Research Institute named after V.N. Gorodkov; Ivanovo, Russian Federation
Published: November 2024

Abstract Aim. To clarify the risk factors for fetal growth retardation based on the study of clinical and anamnestic data and birth outcomes of patients with data on pregnancy complications. Design. Retrospective comparative study. Materials and methods. The study included 120 patients, of which 56 were pregnant women with fetal growth restriction and 64 women with physiological pregnancy, who gave birth in the obstetric clinic of Ivanovo Research Institute of Motherhood and Childhood named after V.N. Gorodkov, of the Ministry of Health of the Russian Federation Anamnesis data, the course of pregnancy and childbirth were analyzed, the results of a questionnaire survey of women, as well as the condition of children at birth were assessed. Results. Analysis of the data obtained showed that risk factors for the formation of fetal growth restriction during pregnancy were: the age of the child’s father over 30 years (odds ratio (OR) = 2,2, 95% confidence interval (CI): 1,1–4,7; p = 0,02), mother’s weight at birth less than 3000 gr. (OR = 2,5, 95% CI: 1,2–5,5; p = 0,02) and maternal small-for-gestational age (OR = 8,7, 95% CI: 2,6–39,4; p = 0,001), maternal nicotine addiction (OR = 3,3, 95% CI: 1,3–8,7; p = 0,02), smoking experience of more than three years (OR = 3,2, 95% CI: 1,2–9,1; p = 0,03), mean arterial pressure above 85 mm Hg. Art. upon registration (OR = 2,2, 95% CI: 1,1–4,6; p = 0,03), history of vulvovaginal candidiasis (OR = 2,3, 95% CI: 1,1–4,8; p = 0,04). It was found that fetal growth restriction, which complicated the course of pregnancy, increases the risk of preterm birth (OR = 16,9, 95% CI: 2,8–376; p = 0,001) and early on-time birth (OR = 3,2, 95% CI: 1,1–12,6; p = 0,04), decompensation of the intrauterine condition of the fetus (OR = 7,2, 95% CI: 2,3–25,8; p = 0,001), asphyxia of the child at birth (OR = 11,9, 95% CI: 1,9–270; p = 0,01), hospitalization in the pediatric intensive care unit (OR = 8,8, 95% CI: 1,3–207; p = 0,03). Conclusion. Risk factors for fetal growth retardation during pregnancy are: maternal low birth weight, maternal nicotine addiction, history of vulvovaginal candidiasis, mean arterial pressure above 85 mmHg upon registration, as well as the age of the child’s father over 30 years. Fetal growth retardation adversely affects the outcomes of pregnancy and childbirth, and the condition of the child at birth. A thorough analysis of predictors and the formation of high-risk groups for the development of this pregnancy complication will allow timely preventive measures and additional examination, which will improve perinatal outcomes. Key words: risk factors, fetal growth restriction, placental insufficiency, perinatal outcomes, prevention.