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Slow Fetal Growth May Predict Perinatal Outcomes

Growth restriction identified on serial exams is associated with increased perinatal mortality

FRIDAY, Oct. 3 (HealthDay News) -- Slow growth between the first and second trimesters of pregnancy is a strong predictor of perinatal death, researchers report in the October issue of Obstetrics & Gynecology.

Nina Gros Pedersen, M.D., of the Copenhagen University Hospital in Copenhagen, Denmark, and colleagues examined the relationship of fetal size and growth between the first and second trimesters, and subsequent adverse pregnancy outcomes among 7,642 pregnancies. Main outcome measures were preterm delivery, smallness for gestational age and perinatal death.

The investigators found that decreases in biparietal diameter growth between the first and second trimesters to less than the 10th and 2.5th conditional centiles occurred in 10.4 percent and 3.6 percent of the pregnancies, respectively. Biparietal diameter growth less than the 10th centile increased the odds of perinatal death before 34 weeks by 16 times, while biparietal diameter growth less than the 2.5th centile increased the odds of perinatal death at any gestation by 7.3 times, the report indicates. Assessments utilizing crown-rump length were not associated with increased risk of perinatal death, but were associated with an increased risk of small-for-gestational-age birth weight.

"Early indication of an increased risk would allow more intensive fetal assessment and surveillance and informed considerations on when to advise early delivery to avoid fetal demise," the authors write. "Our study shows that, in pregnancies with no congenital anomalies, early fetal growth restriction as indicated by serial biparietal diameter measurements is a significant indicator of increased perinatal mortality risk."

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