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Temporal Changes in Fetal and Maternal Parameters in Early-Onset Fetal Growth Restriction:A Multicenter, Retrospective Cohort Study

Title: Temporal Changes in Fetal and Maternal Parameters in Early-Onset Fetal Growth Restriction:A Multicenter, Retrospective Cohort Study
Authors: van de Meent, Mette; Schuit, Ewoud; Ganzevoort,Wessel; Al-Nasiry,Salwan; Bekker, Mireille N; Derks, Jan B; Duvekot,Johannes J; Gordijn,Sanne J; Groenendaal, Floris; Jellema,Reint; Knol,H Marieke; Kooi,Elisabeth M W; Kornelisse,René F; Manten,Gwendolyn T R; Mulder-De Tollenaer,Susanne M; Onland,Wes; van der Wilk,Eline; Wolf,Hans; Lely, A Titia; Kooiman, Judith; MS Verloskunde; Epi Methoden; Cancer; Child Health; Circulatory Health; Other research (not in main researchprogram); Onderzoek Neonatologie; Brain
Publication Year: 2026
Subject Terms: cardiotocography; doppler; early-onset fetal growth restriction; short-term variability; time sequence; Obstetrics and Gynaecology
Description: Objective(s): Timing of birth is complex in early-onset fetal growth restriction (FGR) and the literature is limited regarding the exact sequence of changes in antenatal parameters. This study aimed to examine this sequence in a large early-onset FGR cohort. Design: Multicenter, retrospective cohort study. Setting: Six tertiary care hospitals in the Netherlands. Population: A post hoc analysis of the OPtimal TIming of antenatal COrticosteroids in early-onset fetal growth REstriction (OPTICORE) study was performed. Methods: Repeated measures of antenatal parameters were assessed routinely from diagnosis to birth. Mixed-effects models were used to determine the probability of abnormality (binary) and the trend (Z-score, continuous) over time for each parameter (< 32 and ≥ 32 weeks). Main Outcome Measures: The time sequence of changes in fetal and maternal health parameters from diagnosis to birth in early-onset FGR pregnancies. Results: A total of 1453 patients were included, of whom 1025 patients gave birth < 32 weeks and 428 ≥ 32 weeks, with median gestational ages of 29 + 3 weeks (IQR 27 + 6, 30 + 5) and 34 + 4 weeks (IQR 33 + 0, 37 + 0), respectively. The most apparent changes in fetal parameters in the last days preceding birth comprised: absent/reversed end-diastolic velocity of the umbilical artery and cardiotocography abnormalities. Regarding maternal parameters, an increased probability of antihypertensive agent(s) use was seen shortly preceding birth < 32 weeks. Conclusion(s): This large cohort of early-onset FGR pregnancies provides a time sequence of fetal and maternal health parameters from diagnosis to birth, which could inform clinical management.
Document Type: article in journal/newspaper
File Description: application/pdf
Language: English
ISSN: 1470-0328
Relation: https://dspace.library.uu.nl/handle/1874/468150
Availability: https://dspace.library.uu.nl/handle/1874/468150
Rights: info:eu-repo/semantics/OpenAccess
Accession Number: edsbas.F082F5F
Database: BASE