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Q&A

Ultrasound/Imaging

Poster Session 1

(142) Estimated fetal weight versus abdominal circumference in predicting adverse outcome in fetal growth restriction

Tuesday, February 13, 2024

10:30 AM – 12:00 PM

Location: Prince George's Exhibit Hall CDE, Lower Atrium Level

Primary & Presenting Author(s)

Lydia DeAngelo, BA (she/her/hers)

Medical Student
Cleveland Clinic Lerner College of Medicine of Case Western Reserve University School of Medicine
Cleveland, OH, United States

Coauthor(s)

JM

Justin D. Moore, MD

Cleveland Clinic
Cleveland, OH, United States
MY

Meng Yao, MS

Cleveland Clinic
Cleveland, OH, United States
Sarah C. Graves, MD (she/her/hers)

Fellow
Cleveland Clinic Foundation
Cleveland, OH, United States
CK

Catherine Klammer, MD

Cleveland Clinic Foundation
Cleveland, OH, United States
Lauren Buckley, MD, MS (she/her/hers)

OB/GYN Resident
Cleveland Clinic
Cleveland, OH, United States
Oluyemi Aderibigbe, MBBS

Dr
Cleveland Clinic Obstetrics and Gynecology
Cleveland, OH, United States
AM

Amol Malshe, MBBCH

MFM
Cleveland Clinic
Cleveland, OH, United States
Maeve Hopkins, MD, MA

Cleveland Clinic
Rocky River, OH, United States

Objective:

To identify fetal growth restriction (FGR) based on estimated fetal weight (EFW)< 10%ile, abdominal circumference (AC)< 10%ile or both AC and EFW< 10%ile (AC/EFW< 10%ile). To determine whether EFW< 10%ile, AC< 10%ile or both EFW and AC< 10%ile are associated with adverse neonatal outcomes in singleton FGR pregnancies.

Study Design:

Retrospective cohort study of singleton deliveries with prenatal FGR diagnosis at single tertiary hospital system 1/1/2021-12/31/2021. FGR was defined at earliest abnormal ultrasound by: EFW < 10%ile only, AC < 10%ile only, or both AC/EFW < 10^th%ile. Adverse outcomes included premature delivery, neonatal intensive care unit (NICU) admission, APGAR < 7 at 1 or 5 minutes, neonatal cooling, arterial pH < 7.1, stillbirth, and neonatal death.

Results:

647 patients met inclusion criteria, 340 with AC/EFW < 10%ile, 168 with only EFW < 10%ile, and 139 with only AC < 10%ile. Maternal demographics did not differ between groups. Premature delivery occurred at a higher frequency in patients meeting EFW< 10%ile (21.4%) and AC/EFW < 10%ile (25.6%) compared to AC < 10%ile alone (12.2%) (p= 0.006). Higher rates of NICU admission were observed in EFW < 10%ile (25.6%) and AC/EFW< 10%ile (27.4%), in contrast to AC < 10%ile alone (14.4%) (p = 0.009). Gestational age at delivery in days was earlier in patients with AC/EFW < 10%ile (264 [258, 273]) compared to AC < 10%ile (269 [264, 274]) (p< 0.001). FGR diagnostic group was not associated with other differences in neonatal outcomes. Although not reaching statistical significance, there was higher rate of severe preeclampsia in the AC/EFW < 10%ile (20%) compared to the EFW < 10%ile or AC < 10%ile (13.1%, 13.7%) (p= 0.078).

Conclusion:

In pregnancies diagnosed with FGR, AC/EFW < 10%ile and EFW < 10%ile had increased rates of preterm delivery and NICU admission compared to those with AC < 10%ile alone. Delivery occurred earlier in pregnancies diagnosed with FGR based on AC/EFW < 10%ile and EFW < 10%ile compared to AC < 10%ile. These findings can inform risk counseling in pregnancies diagnosed with fetal growth restriction.