FREQUENCY AND ASSOCIATION OF THE FACTORS INFLUENCING FETAL GROWTH RESTRICTION IN THE REPUBLIC OF KAZAKHSTAN
Introduction: A fetus with fetal growth restriction (FGR), characterized by not reaching its intrauterine growth potential as a result of multiple risk factors, is prone to high morbidity and mortality compared to healthy infants.
The aim of the present study was to evaluate the influence of risk factors hypothesized to negatively affect FGR.
Materials and Methods: The design of this study was a retrospective study, occurring between 1 January 2016 and 31 December 2021. The Inclusion criteria: the presence of ultrasound screening of the first trimester of pregnancy at 10-14 weeks, single pregnancy, pregnancy between 22 and 42 weeks gestation. The exclusion criteria included multiple pregnancies, pregnancies complicated by neonatal chromosomal or structural anomalies of the fetus.
Statistical analysis. All variables were examined to determine whether they were normally distributed. Descriptive statistics included median (Q1 – Q3) for the continuous non-normally distributed variables. Results were compared between newborns with FGR and without FGR. The Mann-Whitney test was used between two groups to compare the means of non-normally variables. The χ2 test was performed for comparing differences in categorical variables between groups. All confidence intervals (CI) were 95%. Statistical significance was defined as p<0.05 for a single test.
Results: In this study, 3211 girls and 3336 boys were born, out of which 85 girls and 75 boys had FGR. 6355 newborns were born alive and 192 newborns were stillborn, of which 136 newborns with FGR were born alive and 24 newborns with FGR were stillborn (p = 0.001). Pregnancies with pre-eclampsia had significantly higher odds of developing FGR than pregnancies without pre-eclampsia (p < 0.001). Placental abruption of normally located placenta; Disorder of maternal-placental blood flow according to Doppler results; fetal distress and oligohydramnios were more common in newborns with FGR than newborns without FGR (p < 0.001). Umbilical cord anomaly in this pregnancy, newborns with FGR occurred more frequently compared to newborns without umbilical cord anomaly (p = 0.029). Low-lying placenta and complete placenta previa according to the ultrasound scan were more common in newborns with FGR compared to newborns without FGR (p = 0.006) and (p = 0.001), respectively.
Conclusions: In our study, FGR was more common in pregnant women with AH, cardiac rhythm disturbance, pulmonary and bronchial diseases and syphilis than in pregnant women without these diseases. FGR was associated with pre-eclampsia, presence of uterine scar, HELLP, placental abruption of a normally located placenta, disorder of maternal-placental blood flow according to Doppler results, oligohydramnios, fetal distress, umbilical cord anomalies, Low-lying placenta and complete placenta previa according to the ultrasound scan.
Meruert Sharipova1, https://orcid.org/0000-0002-5009-7387
Gulyash Tanysheva1, https://orcid.org/0000-0001-9531-5950
Aizhan Shakhanova1, http://orcid.org/0000-0001-8214-8575
Zaituna G. Khamidullina2, https://orcid.org/0000-0002-5324-8486
Khalida K. Sharipova3, https://orcid.org/0000-0001-5553-8156
Zarina K. Zhaksylykova1, https://orcid.org/0009-0007-4997-2184
Elena Y. Lozhkina3, https://orcid.org/0009-0002-3451-4096
Dana K. Kozhakhmetova1, http://orcid.org/0000-0002-8367-1461
Kuat D. Akimzhanov1, https://orcid.org/0000-0002-8608-0771
1 NJSC «Semey Medical University», Semey, Republic of Kazakhstan;
2 NJSC «Astana Medical University», Astana, Republic of Kazakhstan;
3 «Interdistrict Hospital Altai», Altai, Republic of Kazakhstan.
1. ACOG Fetal growth restriction // Practice Bullettin. 2019. № 133:e (204). P. 97–109.
2. Alfirevic Z., Stampalija T., Gyte G.M. Fetal and umbilical Doppler ultrasound in normal pregnancy под ред. Z. Alfirevic, Chichester, UK: John Wiley & Sons, Ltd, 2010. № 8. Р. 1-38.
3. Apel-Sarid L. et al. Term and preterm (<34 and <37 weeks gestation) placental pathologies associated with fetal growth restriction // Archives of Gynecology and Obstetrics. 2010. № 5 (282). P. 487–492.
4. Bardien N. et al. Placental Insufficiency in Fetuses That Slow in Growth but Are Born Appropriate for Gestational Age: A Prospective Longitudinal Study // PloS one. 2016. № 1 (11). P. e0142788.
5. Barker D.J.P. et al. Growth in utero, blood pressure in childhood and adult life, and mortality from cardiovascular disease. // BMJ. 1989. № 6673 (298). P. 564–567.
6. Barker D.J.P. et al. Fetal and placental size and risk of hypertension in adult life // BMJ (Clinical research ed.). 1990. № 6746 (301). P. 259–62.
7. Beckmann C.R., Ling F.W., Herbert W.N., Laube D.W. Obstetrics and gynecology / S. R. Beckmann CR, Ling FW, Herbert WN, Laube DW, Lippincott Williams & Wilkins, 2019. 8th ed. Section II P. 350-366.
8. Billionnet C. et al. Gestational diabetes and adverse perinatal outcomes from 716,152 births in France in 2012. // Diabetologia. 2017. № 4 (60). P. 636–644.
9. Burton G.J., Fowden A.L., Thornburg K.L. Placental Origins of Chronic Disease // Physiological reviews. 2016. № 4 (96). P. 1509–65.
10. Burton G.J., Jauniaux E. Pathophysiology of placental-derived fetal growth restriction // American journal of obstetrics and gynecology. 2018. № 2S (218). P. S745–S761.
11. Chien P.F., Owen P., Khan K.S. Validity of ultrasound estimation of fetal weight // Obstetrics and gynecology. 2000. № 6 Pt 1 (95). P. 856–60.
12. Damhuis S.E., Ganzevoort W., Gordijn S.J. Abnormal Fetal Growth: Small for Gestational Age, Fetal Growth Restriction, Large for Gestational Age: Definitions and Epidemiology // Obstetrics and gynecology clinics of North America. 2021. № 2 (48). P. 267–279.
13. Dewey K.G., Oaks B.M. U-shaped curve for risk associated with maternal hemoglobin, iron status, or iron supplementation // The American journal of clinical nutrition. 2017. № Suppl 6 (106). P. 1694S-1702S.
14. Dittkrist L. et al. Percent error of ultrasound examination to estimate fetal weight at term in different categories of birth weight with focus on maternal diabetes and obesity // BMC pregnancy and childbirth. 2022. № 1 (22). P. 241.
15. Dudley N.J. A systematic review of the ultrasound estimation of fetal weight // Ultrasound in obstetrics & gynecology : the official journal of the International Society of Ultrasound in Obstetrics and Gynecology. 2005. № 1 (25). P. 80–9.
16. Everett T.R., Lees C.C. Beyond the placental bed: Placental and systemic determinants of the uterine artery Doppler waveform // Placenta. 2012. № 11 (33). P. 893–901.
17. Flenady V. et al. Major risk factors for stillbirth in high-income countries: a systematic review and meta-analysis. // Lancet (London, England). 2011. № 9774 (377). P. 1331–40.
18. Georgieff M.K., Krebs N.F., Cusick S.E. The Benefits and Risks of Iron Supplementation in Pregnancy and Childhood // Annual review of nutrition. 2019. № 1 (39). P. 121–146.
19. Hall W. A. et al. A randomized controlled trial of an intervention for infants’ behavioral sleep problems. // BMC pediatrics. 2015. № 1 (15). P. 181.
20. Heaman M. I. et al. Risk factors for spontaneous preterm birth among Aboriginal and non-Aboriginal women in Manitoba // Paediatric and Perinatal Epidemiology. 2005. № 3 (19). P. 181–193.
21. Henry D. et al. Maternal arrhythmia and perinatal outcomes. // Journal of perinatology : official journal of the California Perinatal Association. 2016. № 10 (36). P. 823–7.
22. Iraola A. et al. Prediction of adverse perinatal outcome at term in small-for-gestational age fetuses: comparison of growth velocity vs. customized assessment // Journal of Perinatal Medicine. 2008. № 6 (36). P. 531–5.
23. Julian C. G. et al. Augmented uterine artery blood flow and oxygen delivery protect Andeans from altitude-associated reductions in fetal growth // American journal of physiology. Regulatory, integrative and comparative physiology. 2009. № 5 (296). P. R1564-75.
24. Kildea S.V. et al. Risk factors for preterm, low birthweight and small for gestational age births among Aboriginal women from remote communities in Northern Australia // Women and birth : journal of the Australian College of Midwives. 2017. № 5 (30). P. 398–405.
25. Kingdom J. et al. Development of the placental villous tree and its consequences for fetal growth. // European journal of obstetrics, gynecology, and reproductive biology. 2000. № 1 (92). P. 35–43.
26. Koller O. et al. Fetal growth retardation associated with inadequate haemodilution in otherwise uncomplicated pregnancy // Acta obstetricia et gynecologica Scandinavica. 1979. № 1 (58). P. 9–13.
27. Koller O. The clinical significance of hemodilution during pregnancy // Obstetrical & gynecological survey. 1982. № 11 (37). P. 649–52.
28. Leon D. A. et al. Reduced fetal growth rate and increased risk of death from ischaemic heart disease: cohort study of 15 000 Swedish men and women born 1915-29 // BMJ. 1998. № 7153 (317). P. 241–245.
29. Liu Y. et al. Impact of gestational hypertension and preeclampsia on low birthweight and small-for-gestational-age infants in China: A large prospective cohort study // Journal of clinical hypertension (Greenwich, Conn.). 2021. № 4 (23). P. 835–842.
30. Luo H. et al. Growth in syphilis-exposed and -unexposed uninfected children from birth to 18 months of age in China: a longitudinal study // Scientific reports. 2019. № 1 (9). P. 4416.
31. Macheku G. S. et al. Frequency, risk factors and feto-maternal outcomes of abruptio placentae in Northern Tanzania: a registry-based retrospective cohort study // BMC pregnancy and childbirth. 2015. № 1 (15). P. 242.
32. Marconi A.M. et al. Comparison of fetal and neonatal growth curves in detecting growth restriction // Obstetrics and gynecology. 2008. № 6 (112). P. 1227–1234.
33. McCowan L., Horgan R. P. Risk factors for small for gestational age infants // Best Practice & Research Clinical Obstetrics & Gynaecology. 2009. № 6 (23). P. 779–793.
34. Mifsud W., Sebire N.J. Placental pathology in early-onset and late-onset fetal growth restriction // Fetal diagnosis and therapy. 2014. № 2 (36). P. 117–28.
35. Nelson D. B. et al. Placental pathology suggesting that preeclampsia is more than one disease // American journal of obstetrics and gynecology. 2014. № 1 (210). P. 66.e1–7.
36. Ogge G. et al. Placental lesions associated with maternal underperfusion are more frequent in early-onset than in late-onset preeclampsia // Journal of perinatal medicine. 2011. № 6 (39). P. 641–52.
37. Panaretto K. et al. Risk factors for preterm, low birth weight and small for gestational age birth in urban Aboriginal and Torres Strait Islander women in Townsville // Australian and New Zealand Journal of Public Health. 2006. № 2 (30). P. 163–170.
38. Poon L. C. Y. et al. Birthweight with gestation and maternal characteristics in live births and stillbirths // Fetal diagnosis and therapy. 2012. № 3 (32). P. 156–65.
39. Qin J.-B. et al. Risk factors for congenital syphilis and adverse pregnancy outcomes in offspring of women with syphilis in Shenzhen, China: a prospective nested case-control study // Sexually transmitted diseases. 2014. № 1 (41). P. 13–23.
40. Smith-Bindman R. et al. US Evaluation of Fetal Growth: Prediction of Neonatal Outcomes // Radiology. 2002. № 1 (223). P. 153–161.
41. Society for Maternal-Fetal Medicine Publications Committee [et all]. Doppler assessment of the fetus with intrauterine growth restriction // American journal of obstetrics and gynecology. 2012. № 4 (206). P. 300–8.
42. Sparks T. N. et al. Fundal height: a useful screening tool for fetal growth? // The Journal of Maternal-Fetal & Neonatal Medicine. 2011. № 5 (24). P. 708–712.
43. Steer P.J. Maternal hemoglobin concentration and birth weight // The American Journal of Clinical Nutrition. 2000. № 5 (71). P. 1285S-1287S.
44. Taylor D.J., Lind T. Red cell mass during and after normal pregnancy // BJOG: An International Journal of Obstetrics and Gynaecology. 1979. № 5 (86). P. 364–370.
45. Walker D.-M., Marlow N. Neurocognitive outcome following fetal growth restriction // Archives of Disease in Childhood - Fetal and Neonatal Edition. 2007. № 4 (93). P. F322–F325.
46. Wijesooriya N.S. et al. Global burden of maternal and congenital syphilis in 2008 and 2012: a health systems modelling study // The Lancet. Global health. 2016. № 8 (4). P. e525-33.
47. Xiong X. et al. Anemia during pregnancy in a Chinese population // International Journal of Gynecology & Obstetrics. 2003. № 2 (83). P. 159–164.
48. Zhang X.-H. et al. Effectiveness of treatment to improve pregnancy outcomes among women with syphilis in Zhejiang Province, China // Sexually Transmitted Infections. 2016. № 7 (92). P. 537–541.
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Sharipova М.G., Tanysheva G.A., Shakhanova A.T., Khamidullina Z.G., Sharipova H.K., Zhaksylykova Z.K., Lozhkina E.Yu., Kozhakhmetova D.K., Akimzhanov K.D. Frequency and association of the factors influencing fetal growth restriction in the republic of Kazakhstan // Nauka i Zdravookhranenie [Science & Healthcare]. 2023, (Vol.25) 6, pp. 59-70. doi 10.34689/SH.2023.25.6.007Похожие публикации:
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