(410) Does fetal growth restriction actually resolve? Maternal and neonatal risks with resolved fetal growth restriction

Thursday, January 30, 2025

4:00 PM – 6:00 PM

Submitting Author and Presenting Author(s)

Angela Nakahara, MD

Maternal Fetal Medicine Fellow
University of Tennessee Health Science Center
Memphis, Tennessee, United States

Coauthor(s)

OF

Olivia Feltner, MD

University of Tennessee Health Science Center
Memphis, Tennessee, United States
WF

William Fesmire, MS

University of Tennessee – Department of Preventative Medicine
Memphis, Tennessee, United States
VS

Victoria Schlesinger

University of Tennessee Health Science Center
Memphis, Tennessee, United States
GH

Grace Anne Holladay

University of Tennessee Health Science Center
Memphis, Tennessee, United States
AB

Anna Belk, BS, RDMS

Regional One Health
Memphis, Tennessee, United States
PG

Patricia Goedecke, MS

Statistician
University of Tennessee Health Science Center
Memphis, Tennessee, United States
JW

Jim Wan, PhD

University of Tennessee – Department of Preventative Medicine
Memphis, Tennessee, United States
Kerri Brackney, MD

Assistant Professor of Obstetrics & Gynecology
University of Tennessee Health Science Center
Memphis, Tennessee, United States

Objective: Little guidance exists on the management of FGR that resolves, and potential neonatal outcomes including birth weight and NICU admission are unknown. We compared the likelihood of identifying small for gestational age (SGA) infants in fetuses with resolved FGR (based on estimated fetal weight (EFW) and abdominal circumference (AC) >10th percentile) compared to those without history of FGR.

Study Design: A retrospective case control study of fetal growth ultrasounds (US) performed at our institution from 01/2019-04/2024 was conducted. US evaluating biometric parameters for singleton pregnancies originally meeting criteria for FGR based on EFW or AC < 10th percentile, with resolution of both EFW and AC parameters, were included. Controls were matched based on year of birth, gestational age (GA) and maternal age at delivery. Primary outcome was prevalence of SGA neonate at birth; secondary outcomes were need for NICU admission, GA at birth and mode of delivery. We applied a mixed effects logistic regression model comparing cases and controls.

Results: A total of 140 infants were evaluated. Cases with resolved FGR had a 2.26 RR (95% CI 1.44-3.24) for SGA. When controlling for hypertensive disorders of pregnancy, the RR was 2.31 (95% CI 1.46-3.32). The mean GA of delivery was 37 weeks for both groups (p >0.9) and NICU admission rates were similar (24% vs 24%, p >0.9). Cesarean section (CS) was more likely in pregnancies with resolved FGR (37% vs 26%, p=0.039) and more likely to be performed for non reassuring fetal heart tones (NRFHT) than those without history of FGR (10% vs 2.9%, p=0.025).

Conclusion:
Neonates with history of FGR are more likely to be SGA compared to those with normal growth profile in antenatal period and are more likely to need CS for NRFHT.