OBJECTIVE: To confirm the role of fetal growth restriction (FGR) as a cause of stillbirth, and to compare diagnostic accuracy of customized fetal growth and population-based standards in identifying FGR within a pathological population of early and late stillbirths. METHODS: Retrospective study on a cohort of 189 stillbirths occurred in single pregnancy between January 2006 and September 2011. Unexplained stillbirths, defined by Aberdeen-Wigglesworth and ReCoDe classifications, were evaluated on the basis of fetal birthweight with both Tuscany population and Gardosi customized standards. Unexplained stillbirths have been classified as early or late depending on the gestational age of occurrence. RESULTS: Aberdeen-Wigglesworth classification, applied to the 189 cases of stillbirth, left 94 unexplained cases (49.7%), whereas the ReCoDe classification left only 40 (21%). By applying population standards to the 94 unexplained stillbirths we have identified 31 FGRs (33% of sample), while customized standards identified 54 FGRs (57%). Customised standards identified a larger number of FGRs with respect to population standards during the third trimester (i.e. 51% vs. 25% respectively) than in the second trimester (73% vs. 54% respectively) (p = 0.05). CONCLUSIONS: Customized standards have a higher diagnostic accuracy in identifying FGRs especially during the third trimester.
OBJECTIVE: To confirm the role of fetal growth restriction (FGR) as a cause of stillbirth, and to compare diagnostic accuracy of customized fetal growth and population-based standards in identifying FGR within a pathological population of early and late stillbirths. METHODS: Retrospective study on a cohort of 189 stillbirths occurred in single pregnancy between January 2006 and September 2011. Unexplained stillbirths, defined by Aberdeen-Wigglesworth and ReCoDe classifications, were evaluated on the basis of fetal birthweight with both Tuscany population and Gardosi customized standards. Unexplained stillbirths have been classified as early or late depending on the gestational age of occurrence. RESULTS: Aberdeen-Wigglesworth classification, applied to the 189 cases of stillbirth, left 94 unexplained cases (49.7%), whereas the ReCoDe classification left only 40 (21%). By applying population standards to the 94 unexplained stillbirths we have identified 31 FGRs (33% of sample), while customized standards identified 54 FGRs (57%). Customised standards identified a larger number of FGRs with respect to population standards during the third trimester (i.e. 51% vs. 25% respectively) than in the second trimester (73% vs. 54% respectively) (p = 0.05). CONCLUSIONS: Customized standards have a higher diagnostic accuracy in identifying FGRs especially during the third trimester.
Authors: Robert L Goldenberg; Lulu Muhe; Sarah Saleem; Sangappa Dhaded; Shivaprasad S Goudar; Janna Patterson; Assaye Nigussie; Elizabeth M McClure Journal: J Matern Fetal Neonatal Med Date: 2018-08-23
Authors: Adi L Tarca; Roberto Romero; Dereje W Gudicha; Offer Erez; Edgar Hernandez-Andrade; Lami Yeo; Gaurav Bhatti; Percy Pacora; Eli Maymon; Sonia S Hassan Journal: Am J Obstet Gynecol Date: 2018-02 Impact factor: 8.661
Authors: Susannah Hopkins Leisher; Zheyi Teoh; Hanna Reinebrant; Emma Allanson; Hannah Blencowe; Jan Jaap Erwich; J Frederik Frøen; Jason Gardosi; Sanne Gordijn; A Metin Gülmezoglu; Alexander E P Heazell; Fleurisca Korteweg; Joy Lawn; Elizabeth M McClure; Robert Pattinson; Gordon C S Smith; Ӧzge Tunçalp; Aleena M Wojcieszek; Vicki Flenady Journal: BMC Pregnancy Childbirth Date: 2016-09-15 Impact factor: 3.007
Authors: Matias C Vieira; Sophie Relph; Andrew Copas; Andrew Healey; Kirstie Coxon; Alessandro Alagna; Annette Briley; Mark Johnson; Deborah A Lawlor; Christoph Lees; Neil Marlow; Lesley McCowan; Louise Page; Donald Peebles; Andrew Shennan; Baskaran Thilaganathan; Asma Khalil; Jane Sandall; Dharmintra Pasupathy Journal: Trials Date: 2019-03-04 Impact factor: 2.279