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To determine the principal prognostic factors and neonatal outcomes associated with perinatal death in cases of early-onset intrauterine growth restriction (IUGR) due to placental insufficiency and to define the cutoff point for the risk of perinatal death. A retrospective cohort study conducted with 198 pregnant women with a diagnosis of early-onset IUGR (as detected before the 32nd week of gestational age). The association between the dependent variable (perinatal death) and the independent variables was investigated using a multivariate logistic regression model. The area under the receiver operating characteristic (ROC) curve was calculated to determine the sensitivity and specificity of the adjusted model. A significance level of 5% was established for the entire statistical analysis. Perinatal deaths occurred in 89 (44.9%) of the 198 fetuses with early-onset IUGR. Birthweight &lt;800 grams (OR: 14.73; 95%CI: 4.13–52.54;  p  &lt; .001), postnatal need for mechanical ventilation (OR: 24.56; 95%CI: 5.58–108.08;  p  &lt; .001) and postnatal use of an oxygen hood (OR: 0.09; 95%CI: 0.02–0.39;  p  = .001) remained significantly associated with neonatal death in the multivariate model. The sensitivity, specificity, positive and negative predictive values for birthweight &lt;800 grams and need for mechanical ventilation as predictors of death were, respectively, 84%, 91%, 88%, 88% and 93%, 71%, 60% and 96%, while the values for use of an oxygen hood were, respectively, 15%, 62%, 15% and 62%. The principal determinants of perinatal death in fetuses with early-onset IUGR were birthweight &lt;800 grams, gestational age at delivery &lt;30 weeks and postnatal need for mechanical ventilation as risk factors while postnatal use of an oxygen hood was found to constitute a protective factor.

Prognostic factors and perinatal outcomes in early-onset intrauterine growth restriction due to placental insufficiency