Poster Session 3
Patrick S. Kim, MD (he/him/his)
Resident Physician
Orlando Health Bayfront Hospital
St. Petersburg, FL, United States
Tiffany A. Lowtan, MD
Resident Physician
Orlando Health Bayfront Hospital
St. Petersburg, Florida, United States
David J. Rivera Vazquez, MD
Resident Physician
Orlando Health Bayfront Hospital
St. Petersburg, Florida, United States
Kelsey M. Pozerski, DO
Resident Physician
Orlando Health Bayfront Hospital
St. Petersburg, Florida, United States
Krista Howard, PhD
Professor, Department of Psychology
Texas State University
San Marcos, Texas, United States
Bradley H. Sipe, MD
Maternal-Fetal Medicine Specialist
Johns Hopkins All Children's Hospital
St. Petersburg, Florida, United States
Rachelle Schwartz, DO
Maternal-Fetal Medicine Specialist
Johns Hopkins All Children's Hospital
St. Petersburg, Florida, United States
To determine if an isolated second trimester fetal abdominal circumference (AC) < 10th %tile is an independent risk factor for fetal growth restriction (FGR) and small for gestational age (SGA) neonates.
Study Design:
This multi-center retrospective cohort study analyzed patients who delivered term singletons between 1/1/2019-1/1/2024. The exposed group involved normally grown fetuses with isolated AC’s < 10th %tile, measured between 18 and 24 weeks gestation. Control subjects were randomly selected from the same time period. Congenital anomalies were excluded. Statistical analyses included independent t-tests for continuous variables, chi-squared tests for categorical variables, and binary logistic regression models both unadjusted and adjusted for FGR and SGA.
Results:
Of the 1,213 patients screened, 589 met the inclusion criteria (AC< 10 n=213; Control n=376). The mean AC was 6.3%tile in the exposed group compared to 51.2%tile in the controls. Birthweight in grams (2,782 vs. 3,257, p< 0.001) and %tiles (18.3% vs. 41.8%, p< 0.001) were lower in the AC< 10 group. AC was found to be an independent risk factor for both FGR (AOR 12.5 [6.7, 23.4]) and SGA (AOR 5.08 [3.32, 7.76]). Logistic regressions analysis for primary and secondary outcomes are shown in Table 2. Although there were more pregestational diabetic mothers in the AC< 10 group (10.3% vs. 3.7%, p=0.001), pregestational diabetes was ultimately protective of FGR (AOR 0.15 [0.04, 0.54]). As maternal BMI increased, the likelihood of FGR (AOR 0.95 [0.90, 0.995]) and SGA (AOR 0.94 [0.91, 0.97]) decreased. Demographically, Black patients were more prevalent in the AC< 10 group compared to controls (36.2% vs. 25.8%, p=0.027). There were no differences in parity, gestational diabetes, chronic or gestational hypertension, pre-eclampsia, BMI, or mode of delivery between groups.
Conclusion:
An isolated second trimester AC< 10th %tile in an otherwise normally grown fetus is an independent risk factor for both FGR and SGA. Increased maternal BMI was protective of both FGR and SGA. A history of pregestational diabetes was protective of FGR but not SGA.
