IUGR; Cause and Relationship

Study Overview
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Brief Summary
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Intrauterine growth restriction (IUGR) is a pregnancy complication in about 3-5% of all pregnancies in Sweden. IUGR fetuses are at high risk of morbidity and death. The method used in Sweden to detect IUGR is repeated measurements of pregnant women's symphysis-fundus measure (SF measure). Weight estimation with ultrasound is performed only on indication; stagnant or deplaning SF dimensions or in the event of complications. Only high-risk pregnancies have repeated growth checks during pregnancy from the beginning. There are potential benefits to detecting IUGR fetuses during pregnancy. Still, the effect is questioned. A meta-analysis of randomized studies could not benefit from a routine ultrasound in the third trimester. The scientific purpose of this work is to evaluate the benefits of early detection and care of SGA (small for gestational age)/IUGR (growth-inhibited) fetuses and, if possible, to increase knowledge about this patient group. The hope is that this will lead to a better opportunity to personalize both preventive care and treatment of these women and children.

Detailed Description
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Design: Register-based cohort study. Population: All pregnancies in Stockholm from 2014 to 2017 A Composite outcome for the study is constructed and consists of at least one of the following outcomes HIE (hypoxic-ischemic encephalopathy)2-3 (neonatal convulsions in the fetus after childbirth), Intracranial hemorrhage, Apgar score < 4 at 5 minutes, Arterial umbilical cord pH (potential of hydrogen) < 7.10, Intrauterine fetal death, 6)intrapartal death. Inclusion: All pregnancies in Stockholm with a fetus, born between 2014 and 2017 and without chromosomal abnormalities or other structural abnormalities, will be included in the project.

Official Title
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Intra Uterine Growth Retardation;Causes and Relationship

Conditions
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Intrauterine Growth Restriction

Intervention / Treatment
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* Procedure: ultrasound


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: All pregnancies in Stockholm with a fetus, born between 2014 and 2017 and without chromosomal abnormalities or other serious structural abnormalities, will be included in the project. Exclusion Criteria: Pregnancies with known chromosomal abnormalities or other serious structural abnormalities
Sexes Eligible for Study
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Female

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Early / growth restriction<br>Intrauterine growth restriction with onset before 32 weeks of gestation | Procedure: ultrasound<br>* An extra ultrasound performed during pregnancy<br>|
| Late growth restriction<br>Intrauterine growth restriction with onset after 32 weeks of gestation | Procedure: ultrasound<br>* An extra ultrasound performed during pregnancy<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| The frequency of newborns with an affected perinatal outcome (low Apgar score and or affected acid-base status at labor) | Will the perinatal outcome at delivery( be measured as a low Apgar score at 5 minutes or an affected acid-base status in cord blood) be improved if IUGR(intrauterine growth restriction) is identified before labor | 2014-2017 | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| The frequency of newborns with an affected perinatal outcome (low Apgar score and or affected acid-base status at labor)(2) | Will the outcome changes persist if the group with IUGR will be divided into early- or late-diagnosed IUGR (before and after week 32 of pregnancy)? | January 1th 2014- december 31th 2017 | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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IUGR, SGA