The predictors of poor outcome in early onset fetal growth restriction

The aim of this study was to evaluate the obstetric and sonographic parameters associated with perinatal mortality and neonatal intensive care unit admission (NICU) in pregnancies affected by small for gestational age before 34 weeks gestation. Study recruited 313 singleton pregnancies who were referred if small fetal size was suspected due to clinical evaluation in the antenatal setting. The primary outcomes for this study were perinatal mortality and NICU admission. The outcomes were analyzed based on predictors including gestational age at enrollment, gestational age at delivery, abnormal umbilical artery Doppler, preeclampsia, oligohydramnios, birth-weight, birthweight percentile, gender and cesarean delivery. Neonatal intensive care unit admission rate was 64%. Gestational at delivery was detected to be the significant independent predictors for NICU admission. The presence of preeclampsia, oligohydroamnios and abnormal umbilical artery Doppler were detected to be non-independent predictors. Perinatal mortality rate was 4.5%. GA at delivery was detected to be the significant independent predictor for perinatal mortality. The presence of preeclampsia and abnormal umbilical artery Doppler were detected to be non-independent predictors. The predictive accuracy of GA at delivery as a marker for NICU admission and perinatal mortality were determined by receiver-operating curves (ROC) analysis with area under curve (AUC): 0.97 (95% CI: 0.95-0.99) and AUC: 0.93 (95% CI: 0.87-0.99), respectively.