Clinical and anamnestic risk factors and prediction models for the development of fetal growth restriction
- 作者: Gasymova S.R.1, Tyutyunnik V.L.1, Kan N.E.1, Volochaeva M.V.1, Donnikov A.E.1
-
隶属关系:
- Academician V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology, Ministry of Health of the Russian Federation
- 期: 编号 10 (2024)
- 页面: 53-59
- 栏目: Original Articles
- URL: https://journal-vniispk.ru/0300-9092/article/view/270936
- DOI: https://doi.org/10.18565/aig.2024.166
- ID: 270936
如何引用文章
开放存取
##reader.subscriptionAccessGranted##
订阅存取
详细
Objective: To analyze clinical and anamnestic risk factors and develop prediction models for early- and late-onset fetal growth restriction.
Materials and methods: A cross-sectional study was conducted at the V.I. Kulakov NMRC for OG&P of Minzdrav of Russia, involving 382 pregnant women. Group 1 included 110 pregnant women with fetal growth restriction, whereas Group 2 included 272 women with pregnancies without fetal growth restriction. An analysis of the somatic and obstetric-gynecological history and course of the current pregnancy in both groups was performed. Prediction models for the likelihood of developing early- and late-onset fetal growth restriction were developed.
Results: In group 1, a history of arterial hypertension [10/110 (9.1%) vs. 6/272 (2.2%), p=0.045, OR=0.226 (95% CI 0.052–0.979)], chronic pyelonephritis [8/110 (7.3%) vs. 2/272 (0.7%), p=0.025, OR=0.094 (95% CI 0.010–0.865)], chronic endometritis [8/110 (7.3%) vs. 58/272 (21.3%), p=0.02, OR=0.82 (95% CI 0.015–10.353)], and a history of giving birth to children with growth restriction in previous pregnancies [8/110 (7.3%) vs. 2/272 (0.7%), p=0.025, OR=0.094 (95% CI 0.010–0.865)] were significantly more common than in group 2. During the current pregnancy, the following complications were significantly more prevalent in group 1 than in group 2: threatened miscarriage [35/110 (31.8%) vs. 64/272 (23.5%), p=0.04, RR=1.97 (95% CI 1.03–3.75)], preeclampsia [11/110 (10%) vs. 9/272 (3.3%), p=0.01, RR=3.53 (95% CI 1.37–9.08)], chronic arterial hypertension [11/110 (10%) vs. 11/272 (4.0%), p=0.02, RR=2.84 (95% CI 1.15–7.01)], and placenta previa [5/110 (4.5%) vs. 5/272 (1.8%), p=0.01, RR=0.84 (95% CI 0.42–1.68)]. Significant predictors of fetal growth restriction included a history of having a child with growth restriction, placenta previa, obesity, and preeclampsia. Based on the identified predictors, mathematical predictive models were developed to determine the likelihood of fetal growth restriction.
Conclusion: The developed predictive models for early- and late-onset fetal growth restriction can help reduce the incidence of pregnancy complications and improve perinatal outcomes.
作者简介
Shagane Gasymova
Academician V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology, Ministry of Health of the Russian Federation
编辑信件的主要联系方式.
Email: shagane2501@mail.ru
ORCID iD: 0009-0001-2626-6670
Junior Researcher, Department of Fetal Medicine of the Institute of Obstetrics; Diagnostic Medical Sonographer, Department of Ultrasound and Functional Diagnostics; Obstetrician-Gynecologist
俄罗斯联邦, MoscowVictor Tyutyunnik
Academician V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology, Ministry of Health of the Russian Federation
Email: tioutiounnik@mail.ru
ORCID iD: 0000-0002-5830-5099
SPIN 代码: 1963-1359
Scopus 作者 ID: 56190621500
Researcher ID: B-2364-2015
Professor, Dr. Med. Sci., Leading Researcher at the Center for Scientific and Clinical Research
俄罗斯联邦, MoscowNatalia Kan
Academician V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology, Ministry of Health of the Russian Federation
Email: kan-med@mail.ru
ORCID iD: 0000-0001-5087-5946
SPIN 代码: 5378-8437
Scopus 作者 ID: 57008835600
Researcher ID: B-2370-2015
Professor, Dr. Med. Sci., Deputy Director of Science
俄罗斯联邦, MoscowMaria Volochaeva
Academician V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology, Ministry of Health of the Russian Federation
Email: volochaeva.m@yandex.ru
ORCID iD: 0000-0001-8953-7952
PhD, Senior Researcher at the Department of Regional Cooperation and Integration; Physician at the Maternity Department No. 1
俄罗斯联邦, MoscowAndrey Donnikov
Academician V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology, Ministry of Health of the Russian Federation
Email: donnikov@dna-technology.ru
ORCID iD: 0000-0003-3504-2406
PhD, Head of the Laboratory of Molecular Genetic Methods
俄罗斯联邦, Moscow参考
- Brosens I., Pijnenborg R., Vercruysse L., Romero R. The «Great Obstetrical Syndromes» are associated with disorders of deep placentation. Am. J. Obstet. Gynecol. 2011; 204(3): 193-201. https://dx.doi.org/110.1016/ j.ajog.2010.08.009.
- Ганичкина М.Б., Мантрова Д.А., Кан Н.Е., Тютюнник В.Л., Хачатурян А.А., Зиганшина М.М. Ведение беременности при задержке роста плода. Акушерство и гинекология. 2017; 10: 5-11. [Ganichkina M.B., Mantrova D.A., Kan N.E., Tyutyunnik V.L., Khachaturyan A.A, Ziganshina M.M. Management of pregnancy during fetal growth retardation. Obstetrics and Gynecology. 2017; (10): 5-11. (in Russian)]. https://dx.doi.org/10.18565/aig.2017.10.5-11.
- Priante E., Verlato G., Giordano G., Stocchero M., Visentin S., Mardegan V., Baraldi E. Intrauterine growth restriction: new insight from the metabolomic approach. Metabolites. 2019; 9(11): 267. https://dx.doi.org/10.3390/metabo9110267.
- Sharma D., Shastri S., Sharma P. Intrauterine growth restriction: antenatal and postnatal aspects. Clin. Med. Insights Pediatr. 2016; 10: 67-83. https:// dx.doi.org/10.4137/CMPed.S40070.
- Якубова Д.И., Игнатко И.В., Меграбян А.Д., Богомазова И.М. Особенности течения беременности и исходы родов при различных фенотипах задержки роста плода. Акушерство и гинекология. 2022; 8: 54-62. [Yakubova D.I., Ignatko I.V., Megrabian A.D., Bogomazova I.M. Features of pregnancy course and delivery outcomes in various phenotypes of fetal growth restriction. Obstetrics and Gynecology. 2022; (8): 54-62. (in Russian)]. https:// dx.doi.org/10.18565/aig.2022.8.54-62.
- Burton G.J, Jauniaux E. Pathophysiology of placental-derived fetal growth restriction. Am. J. Obstet. Gynecol. 2018; 218(2S): S745-61. https:// dx.doi.org/10.1016/j.ajog.2017.11.577.
- Hendrix N., Berghella V. Non-placental causes of intrauterine growth restriction. Semin. Perinatol. 2008; 32(3): 161-5. https://dx.doi.org/10.1053/ j.semperi.2008.02.004.
- Serin S., Bakacak M., Ercan Ö., Köstü B., Avci F., Arıkan D., Kıran G. The evaluation of Nesfatin-1 levels in patients with and without intrauterine growth restriction. J. Matern. Fetal Neonatal Med. 2016; 29(9): 1409-13. https:// dx.doi.org/10.3109/14767058.2015.1049524.
- Tao Z., Chen Y., He F., Tang J., Zhan L., Hu H. et al. Alterations in the gut microbiome and metabolisms in pegnancies with ffetal growth restriction. Microbiol. Spectr. 2023; 11(3): e0007623. https://dx.doi.org/10.1128/spectrum.00076-23.
- Tanner L.D., Brock A C., Chauhan S.P. Severity of fetal growth restriction stratified according to maternal obesity. J. Matern. Fetal Neonatal Med. 2022; 35(10): 1886-90. https://dx.doi.org/10.1080/14767058.2020.1773427.
- Salmeri N., Ca rbone I.F., Cavoretto P.I., Farina A., Morano D. Epigenetics beyond Fetal growth restriction: A comprehensive overview. Mol. Diagn. Ther. 2022; 26(6): 607-26. https://dx.doi.org/10.1007/s40291-022-00611-4.
- Lees C., Marlow N., Arabin B., Bilardo C.M., Brezinka C., Derks J.B. et al; TRUFFLE Group. Perinatal morbidity and mortality in early-onset fetal growth restriction: cohort outcomes of the trial of randomized umbilical and fetal flow in Europe (TRUFFLE). Ultrasound Obstet. Gynecol. 2013; 42 (4): 400-8. https://dx.doi.org/10.1002/uog.
- Allen V.M., Joseph K., Murphy K.E., Magee L.A., Ohlsson A. The effect of hypertensive disorders in pregnancy on small for gestational age and stillbirth: a population based study. BMC Pregnancy Childbirth. 2004; 4(1): 17. https://dx.doi.org/10.1186/1471-2393-4-17.
- Zhang H.G., Yang L., Qiao Z.X., Guo W. Effect of gestational hypertension on fetal growth restriction, endocrine and cardiovascular disorders. Asian J. Surg. 2022; 45 (4): 1048-9. https://dx.doi.org/10.1016/j.asjsur.2022.01.050.
- Пестрикова Т.Ю., Юрасова Е.А., Ткаченко В.А. Плацентарная недостаточность как базовая патология осложнений и исходов гестационного периода. Российский вестник акушера-гинеколога. 2020; 20(1): 5-15. [Pestrikova T.Iu., Iurasova E.A., Tkachenko V.A. Placental insufficiency as the underlying condition of the complications an outcomes of the gestation period. Russian Bulletin of Obstetrician-Gynecologist. 2020; 20(1): 5-15. (in Russian)]. https://dx.doi.org/10.17116/rosakush2020200115.
- Тапильская Н.И., Мельников К.Н., Кузнецова И.А., Глушаков Р.И. Плацентарная недостаточность и синдром задержки роста плода: этиология, профилактика, лечение. Медицинский Aлфавит. 2020; 4: 6-10. [Tapilskaya N.I., Mel’nikov K.N., Kuznetsova I.A., Glushakov R.I. Placental insufficiency and fetal growth restiction: etiology, prevention, and treatment. Medical Alphabet. 2020; (4): 6-10. (in Russian)]. https:// dx.doi.org/10.33667/2078-5631-2020-4-6-10.
- Diguisto C., Le Gouge A., Marchand M.S., Megier P., Ville Y., Haddad G. et al; Groupe de Recherche en Obstétrique et Gynécologie (GROG). Low-dose aspirin to prevent preeclampsia and growth restriction in nulliparous women identified by uterine artery Doppler as at high risk of preeclampsia: A double blinded randomized placebo-controlled trial. PLoS One. 2022; 17(10): e0275129. https://dx.doi.org/10.1371/journal.pone.0275129.
- Lin L., Guo Y.N., Xu X., Huang L.P., Yang Q.P., Yan J.Y. Analysis of maternal and fetal outcomes and establishment of prediction model of vaginal delivery in pregnant women with pre-eclampsia complicated with fetal growth restriction. Eur. Rev. Med. Pharmacol. Sci. 2023; 27(20): 9947-954. https:// dx.doi.org/10.26355/eurrev_202310_34173.
- Saraswat L., Bhattacharya S., Maheshwari A., Bhattacharya S. Maternal and perinatal outcome in women with threatened miscarriage in the first trimester: a systematic review. BJOG. 2010; 117(3): 245-57. https://dx.doi.org/10.1111/j.1471-0528.2009.02427.x.
- Wijesiriwardana A., Bhattacharya S., Shetty A., Smith N., Bhattacharya S. Obstetric outcome in women with threatened miscarriage in the first trimester. Obstet. Gynecol. 2006; 107(3): 557-62. https://dx.doi.org/10.1097/ 01.AOG.0000199952.82151.de.
- McLindon L.A., James G., Beckmann M.M., Bertolone J., Mahomed K., Vane M. et al. Progester.one for women with threate.ned miscarriage (STOP trial): a pla cebo-controlled randomized clinical trial. Hum. Reprod. 2023; 38(4): 560-8. https://dx.doi.org/10.1093/humrep/dead029.
- Волочаева М.В., Кан Н.Е., Тютюнник В.Л., Амирасланов Э.Ю., Леонова А.А., Солдатова Е.Е. Клинико-анамнестические факторы в прогнозировании и диагностике задержки роста плода. Акушерство и гинекология. 2023; 9: 82-90. [Volochaeva M.V., Kan N.E., Tyutyunnik V.L., Amiraslanov E.Yu, Leonova A.A., Soldatova E.E. Clinical and anamnestic factors in the prediction and diagnosis of fetal growth retardation. Obstetrics and Gynecology. 2023; (9): 82-90. (in Russian)]. https://dx.doi.org/10.18565/aig.2023.9.82-90.
补充文件
