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OC15.04: Perinatal outcome of appropriate‐weight fetuses with decelerating growth

Objectives: Growth deceleration has been acknowledged as a risk factor for perinatal complications and a criterion of late fetal growth restriction (FGR). The aim of this study was to assess the perinatal outcome of fetuses dropping by ≥50 estimated fetal weight (EFW) centiles while remaining > 10th centile between the second and third trimester. Methods: This is a non-concurrent cohort study of singleton pregnancies progressing after 32+0 weeks, who had their secondand third-trimester scans at our institutions were enrolled in the study. The perinatal outcome of AGA fetuses dropping more than 50 centiles was compared to that of fetuses with FGR, small for gestational age (SGA) and non-decelerating appropriate for gestational age (AGA-ND). The primary perinatal outcomes were perinatal death and neonatal intensive care (NICU) admission. Emergency Caesarean section rate was assessed as a secondary outcome. Results: Our analysis included 4394 cases. Compared to non-decelerating SGA, fetuses crossing ≥50 centiles had higher rates of NICU admission[CC1] (2% and 3.5% respectively, odds ratio [OR] 1.8, 95% confidence interval [CI] CI 1.1-3.1) and perinatal death (1% and 0.3% respectively, OR 3.8, 95%CI 1.3-11.4). Regression analysis showed that significant predictors for perinatal death included maternal age, gestational age at birth, decelerating growth ≥50 centiles, conception through ART and third-trimester cerebroplacental ratio (CPR) centile (AUC 0.801). The significant independent predictors for NICU admission included maternal age, gestational age at birth and FGR (area under the curve [AUC] 0.851). Conclusions: AGA fetuses that cross > 50 EFW centiles between the second and third trimester are at increased risk of adverse perinatal outcome and it seems advisable that they are managed as typical FGR cases.