Subsequent pregnancy outcome after first pregnancy with normotensive early-onset intrauterine growth restriction at <34 weeks of gestation.

OBJECTIVE: The aim of this study was to evaluate maternal and fetal outcome of the subsequent pregnancy of primiparous women with a history of early-onset intrauterine growth restriction (IUGR), prompting delivery before 34 weeks of gestation, without concomitant maternal hypertensive disease.
DESIGN: Retrospective cohort study.
SETTING: Tertiary center in the Netherlands. POPULATION: Women with a normotensive first pregnancy complicated by early-onset severe IUGR, prompting delivery before 34 weeks of gestation.
METHODS: Reproductive follow-up data were recorded for 22 women with a normotensive first pregnancy complicated by early-onset severe IUGR before 34 weeks, referred to the University Medical Centre Utrecht, the Netherlands, between 1993 and 2005. MAIN OUTCOME MEASURES: Main outcome measures were recurrent IUGR, perinatal mortality, preterm delivery, preeclampsia (PE), pregnancy-induced hypertension, and other major obstetric complications, for example placental abruption.
RESULTS: Mean gestational age at delivery was 29.4 weeks for the index pregnancy compared to 36.4 weeks for the next pregnancy. IUGR recurred in six pregnancies (27.3%). Four subsequent pregnancies were complicated by hypertensive disorders. Perinatal mortality was 72.7% in the index pregnancy, compared to 13.6% in the second pregnancy. Overall, 11 women (54.5%) had an uneventful pregnancy.
CONCLUSION: Women with first pregnancy early-onset IUGR, without concomitant maternal hypertensive disease, frequently develop severe perinatal complications in their subsequent pregnancy.