Pathogenetic associations of indicators of prenatal screening of the firsr trimester of pregnancy with fetal growth retardation

Abstract

Objective. To determine the relationship between the indicators of prenatal screening of the 1st trimester and the intrauterine growth retardation (IUGR).

Materials and methods. A prospective cohort study was carried out. Group 1 included 75 patients with fetal intrauterine growth retardation, group 2 – 414 women who gave birth to a live, full-term healthy baby with normal weight and height parameters. In all patients, the anamnestic parameters, indicators of PAPP-A, b-hCG, PlGF, thickness of the collar space and the pulsation index of the uterine arteries (PI UA) were compared.

Results. A number of significant differences in the anamnestic parameters were found between the groups. In group 1, multiparous women were met more often (16 % compared with 2.9% in group 2, p<0.001), women after сesarean section (13.3% and 5.6%, respectively, p=0.013), women with a history of spontaneous and artificial abortions (46.7% and 34.1 %, p=0.036). In addition, in group 1, patients were more likely to have uterine myoma – in 9.3 % versus 3.4% in group 2 (p=0.019). In group 1, during the first trimester screening, PAPP-A values ​​were lower – 1.238 (0.68–2.05) IU/ml versus 2.25 (1.28–3.9) IU/ml in group 2 (p<0.001), and PlGF – 13.73 (10.22–19.09) IU/ml versus 17.19 (12.1–25.38) in group 2 (p=0.002). There were no significant differences in the level of b-hCG. The average pulsation index of the uterine arteries, on the contrary, in group 1 in the first trimester was higher than in group 2 – 1.73 (1.42–2.11) and 1.55 (1.32–1.85), respectively (p=0.024).

Conclusions. Thus, a number of anamnestic data and screening indicators for the first trimester have a statistically significant relationship with the presence of IUGR of the fetus; therefore, these indicators can be used to assess the risk of this pregnancy complication.

Keywords

Small-for-gestational-age fetuses / IUGR / prenatal screening / great obstetric syndromes / antenatal fetal death / prediction and projection

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RIGHTS & PERMISSIONS

Dektyarev A.A., Kudryavtseva E.V., Kovalev V.V.