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Endocrine Abstracts (2017) 51 OC4.8 | DOI: 10.1530/endoabs.51.OC4.8

BSPED2017 Oral Communications Oral Communications 4 (8 abstracts)

Impact of risk factors for Fetal Growth Restriction (FGR) on intrauterine growth and birthweight

Reena Perchard , Lucy Higgins , Edward Johnstone & Peter Clayton

Faculty of Biology, Medicine & Health, School of Medical Sciences, University of Manchester, Manchester, UK.

Background: Abnormal uterine artery Doppler (UtAD) at 23 weeks is considered to be a risk factor for FGR. However, the incidence of being born small for gestational age (SGA) in those with abnormal Doppler is not defined.

Aims: 1. To determine the incidence of birthweight<2nd centile (BW<C2nd) in pregnancies at high risk of FGR.

2. To determine the effect of specific antenatal FGR risk factors on fetal growth trajectory and birthweight.

Methods: Data were obtained from women seen in a clinic for those at high risk of FGR. Entry criteria were low first trimester PAPP-a or second trimester raised inhibin +/− AFP. Pregnancies were categorised according to FGR risk subgroup; small placenta (<10 cm) and abnormal 23 week UtAD (defined by pulsatility index>1.3MoM, resistance index>0.7MoM +/− notching on one or both waveforms (group A), small placenta & normal UtAD (B), normal placenta & abnormal UtAD (C), normal placenta & normal UtAD (D). Estimated fetal weight and birthweight centiles were calculated, customised for maternal height, weight, ethnicity, gestation and sex.

Results: 226 pregnancies that resulted in livebirths >34 weeks gestation were analysed (A; 16, B; 18, C; 40 and D; 152) of which, 20 (9%) were SGA births. The proportion of babies with BW< C2nd was highest in group A (4/16, 25%), compared with group B (1/17, 6%), C (9/40, 23%) and D (6/152, 4%). ANOVA analysis of fetal growth trajectories between 23 weeks and birth showed differences between FGR risk groups in Δ weight (A=2.10 kg, B=2.73, C=2.42, D=2.66, P=0.001). Mean birthweight (A=2.64 kg, B=3.33, C=3.02, D=3.26, P<0.01) and mean birthweight centiles (A=15.8th, B=36.6th, C=28.3rd, D=37.9th, P=0.008) were also significantly different.

Conclusions: In pregnancies considered to be at higher risk of FGR, 9% were born SGA, rising to 25% for those with a small placenta and abnormal UtAD. Serum markers combined with UtAD and to a lesser extent, placental size can be used to identify adverse growth trajectory and small size at birth.

Volume 51

45th Meeting of the British Society for Paediatric Endocrinology and Diabetes

British Society for Paediatric Endocrinology and Diabetes 

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