Does detection of fetal growth restriction improve neonatal outcomes?
Web of Science
AuthorSelvaratnam, RJ; Wallace, EM; Treleaven, S; Hooper, SB; Davis, PG; Davey, M-A
Source TitleJournal of Paediatrics and Child Health
Obstetrics and Gynaecology
Document TypeJournal Article
CitationsSelvaratnam, R. J., Wallace, E. M., Treleaven, S., Hooper, S. B., Davis, P. G. & Davey, M. -A. (2020). Does detection of fetal growth restriction improve neonatal outcomes?. JOURNAL OF PAEDIATRICS AND CHILD HEALTH, 57 (5), pp.677-683. https://doi.org/10.1111/jpc.15310.
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AIM: Timely delivery of fetal growth restriction (FGR) is a balance between avoiding stillbirth and minimising prematurity. We sought to assess the neonatal outcomes for babies suspected of FGR, both true and false positives. METHODS: This population cohort study examined all singleton births in Victoria, Australia from 2000 to 2017 (n = 1 231 415). Neonatal morbidities associated with neonatal intensive care unit (NICU) admission were assessed for babies born ≥32 weeks' with severe FGR (<3rd centile) and babies with birthweight ≥10th centile who were iatrogenically delivered for suspected FGR. RESULTS: Babies with severe FGR iatrogenically delivered for suspected FGR were more likely to require NICU admission than babies with severe FGR who were not detected (3.0% vs. 1.1%, P < 0.001). After adjusting for potential confounders, the odds of NICU admission were increased (adjusted odds ratio (aOR) = 3.00, 95% confidence interval = 2.45-3.67; P < 0.001). Rates of NICU admission were also higher in ≥10th centile babies iatrogenically delivered for suspected FGR than for ≥10th centile babies who entered labour spontaneously (1.8% vs. 0.5%, P < 0.001). After adjustments, the odds of NICU admission were increased (aOR = 3.91, 95% confidence interval = 3.40-4.49; P < 0.001). NICU admissions were associated with morbidities related to iatrogenic prematurity. CONCLUSIONS: Detection and planned delivery of FGR reduces stillbirth but may be associated with increased neonatal morbidity related to iatrogenic prematurity.
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