Document Detail


Perinatal variables and neonatal outcomes in severely growth restricted preterm fetuses.
MedLine Citation:
PMID:  20804344     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To investigate the impact of severe preterm intrauterine growth restriction on perinatal and neonatal outcomes. DESIGN: Retrospective cohort study. SETTING: Tertiary referral fetal medicine unit in London. POPULATION: A total of 60 pregnancies affected by early onset severe intrauterine growth restriction with fetal abdominal circumference below the third centile and abnormal arterial or venous Dopplers between October 2003 and October 2007, and control cohort of 77 appropriate-for-gestational age preterm neonates. METHODS: Cases were identified from the departmental databases. The neonatal outcomes in 44 growth restricted survivors were compared with 77 gestation matched appropriate-for-gestational age preterm neonates. MAIN OUTCOME MEASURES: Neonatal morbidity and neonatal mortality. RESULTS: Of the 60 pregnancies affected by severe intrauterine growth restriction, seven were terminated, nine resulted in stillbirth and 44 resulted in live births. The growth restricted neonates had increased odds of developing respiratory distress compromise (odds ratio (OR) 2.5, 95% confidence interval (CI) 1.1-6.2) and thrombocytopenia (OR 9.4, 95%CI 2.9-30.8) in comparison to average-for-gestational age cohorts. We also noted an increased risk of neonatal sepsis (OR 2.5, 95%CI 1.1-6.0) and necrotising enterocolitis (OR 9.7, 95%CI 1.1-86.0). Sepsis was the major contributing factor towards neonatal mortality in the growth restricted cohorts. CONCLUSION: Despite intensive fetal surveillance and tertiary level neonatal care, the survival for growth restricted fetuses before 28 weeks gestation remains poor with neonatal outcome predominantly affected by respiratory morbidity, sepsis and metabolic compromise.
Authors:
Neelam Engineer; Sailesh Kumar
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Acta obstetricia et gynecologica Scandinavica     Volume:  89     ISSN:  1600-0412     ISO Abbreviation:  Acta Obstet Gynecol Scand     Publication Date:  2010 Sep 
Date Detail:
Created Date:  2010-08-31     Completed Date:  2010-09-28     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0370343     Medline TA:  Acta Obstet Gynecol Scand     Country:  England    
Other Details:
Languages:  eng     Pagination:  1174-81     Citation Subset:  IM    
Affiliation:
Centre for Fetal Care, Queen Charlotte's and Chelsea Hospital, Imperial College, London, United Kingdom. nejengineer@aol.com
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MeSH Terms
Descriptor/Qualifier:
Abortion, Induced / statistics & numerical data
Acidosis / epidemiology
Adolescent
Adult
Anemia, Neonatal / epidemiology
Case-Control Studies
Cohort Studies
Enterocolitis, Necrotizing / epidemiology
Female
Fetal Growth Retardation / epidemiology*
Humans
Hypoglycemia / epidemiology
Infant Mortality
Infant, Newborn
Infant, Premature
Intensive Care Units, Neonatal
Length of Stay / statistics & numerical data
Live Birth / epidemiology
Middle Aged
Pre-Eclampsia / epidemiology
Pregnancy
Pregnancy Outcome*
Premature Birth
Respiratory Distress Syndrome, Newborn / epidemiology,  therapy
Retrospective Studies
Sepsis / epidemiology
Severity of Illness Index
Stillbirth / epidemiology
Thrombocytopenia / epidemiology
Umbilical Arteries / ultrasonography

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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