Premium
Does the Presence of Risk Factors for Fetal Growth Restriction Increase the Probability of Antenatal Detection? A F rench National Study
Author(s) -
Monier Isabelle,
Blondel Béatrice,
Ego Anne,
Kaminski Monique,
Goffinet François,
Zeitlin Jennifer
Publication year - 2016
Publication title -
paediatric and perinatal epidemiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.667
H-Index - 88
eISSN - 1365-3016
pISSN - 0269-5022
DOI - 10.1111/ppe.12251
Subject(s) - medicine , percentile , small for gestational age , confidence interval , obstetrics , fetal growth , pregnancy , poisson regression , pediatrics , gestational age , body mass index , fetus , population , environmental health , statistics , mathematics , biology , genetics
Background Screening for fetal growth restriction ( FGR ) is a major component of prenatal care. We investigated whether the presence of maternal and pregnancy risk factors for FGR improves the antenatal suspicion of FGR for infants born small‐for‐gestational age ( SGA ) as well as their impact on screening specificity. Methods Data are from a representative sample of births from the 2010 F rench N ational P erinatal S urvey ( n = 14 100). Detection of FGR was determined by a suspicion of FGR noted in medical charts. Analyses were performed for singleton infants with birthweight under the 10th percentile ( SGA ), under the 3rd percentile (severely SGA ), and above the 10th percentile (false positives) of F rench references. We studied risk factors for FGR (medical and obstetric conditions, advanced maternal age, nulliparity, body mass index and smoking) using multivariable Poisson regression to derive adjusted risk ratios (aRR). Results Of SGA infants, 21.7% were suspected of FGR . The presence of obstetric and medical risk factors for FGR was associated with higher suspicion among SGA infants [ RR 2.1, 95% confidence interval ( CI ) 1.7, 2.7]. However, despite the presence of these factors, 60% and 40% of SGA and severely SGA infants, respectively, were not suspected of FGR . Two per cent of normal birthweight infants were suspected of FGR , increasing to 5% when obstetric and medical risk factors were present. Smoking and older maternal age were unrelated to suspicion while females were more likely to be suspected of FGR . Conclusion Our results suggest that better risk assessment could improve antenatal identification of FGR . Sex‐specific fetal growth references should be used to avoid systematic bias linked to sex.