Appropriate Delivery Timing in Fetuses with Fetal Growth Restriction to Reduce Neonatal Complications: A Case—Control Study in Romania
Abstract
:1. Introduction
2. Materials and Methods
2.1. Study Design and Settings
2.2. Participants
2.3. Variables, Data Sources, and Measurement
2.4. Statistical Analysis
3. Results
3.1. Characteristics of Pregnant Women with Early Onset FGR
3.2. Fetal Doppler Findings
3.3. Overall Fetal Outcomes
3.4. Fetal Outcomes According to the Time of Delivery, in Infants Born at Less than 30 Weeks of Gestation
3.5. Fetal Outcomes According to the Time of Delivery, in Infants Born between 30 and 34 Weeks of Gestation
4. Discussion
4.1. Key Results
4.2. Interpretation
4.3. Limitations
4.4. Clinical Implications
4.5. Research Implications
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Parameters | Overall | Group 1 (Cases) n = 120 | Group 2 (Control) n = 85 | p Value |
---|---|---|---|---|
Age [mean ± SD] | 29.48 ± 5.44 | 29.31 ± 5.34 | 29.72 ± 5.61 | 0.59 |
Height [median (IQR)] | 162 (8) | 162 (9) | 162 (8) | 1.00 |
Weight [median (IQR)] | 74 (14) | 73 (14) | 74 (14) | 0.58 |
Gravidity [median (IQR)] | 1 (1) | 1 (1) | 1 (1) | 0.83 |
Parity [median (IQR)] | 0 (1) | 0 (1) | 0 (1) | 0.72 |
WG on diagnosis [median (IQR)] | 31 (2) | 31 (2) | 31 (2) | 0.75 |
WG on delivery [median (IQR)] | 32 (2) | 32 (3) | 33 (3) | 0.12 |
Parameters | Overall | Group 1 (Case) | Group 2 (Control) | p Value |
---|---|---|---|---|
UA AEDF | 115/56.1% | 90/75.0% | 25/29.4% | <0.001 |
UA REDF | 69/33.7% | 30/25.0% | 39/45.9% | 0.002 |
DVA absent | 14/6.8% | - | 14/16.5% | NA |
Reversed DVa | 7/3.4% | - | 7/8.2% | NA |
Abnormal CTG | 9/4.4% | 1/0.8% | 8/9.4% | 0.004 |
Abnormal BPP | 5/2.4% | 1/0.8% | 4/4.7% | 0.09 |
Parameters | Overall | Case Group | Control Group | p Value |
---|---|---|---|---|
Neonatal death | 4/2.0% | 1/0.8% | 3/3.5% | 0.19 |
Bronchopulmonary dysplasia | 10/4.9% | 1/0.8% | 9/10.6% | 0.002 |
IVH grades I/II | 55/26.8% | 29/24.2% | 24/28.2% | 0.52 |
IVH grades III/IV | 25/12.2% | 8/6.7% | 17/20.0% | 0.004 |
NEC | 2/1.0% | - | 2/2.4% | NA |
Parameters | Total (n = 49) | Case Group (Delivery According to UA) (n = 31) | Control Group (Delivery According to DV) (n = 18) | p Value |
---|---|---|---|---|
Neonatal death | 4/8.2% | 1/3.2% | 3/16.7%% | 0.13 |
Bronchopulmonary dysplasia | 10/4.9% | 1/3.2% | 9/50.0% | <0.001 |
IVH I/II | 25/51.0% | 23/74.2% | 2/11.1% | <0.001 |
IVH III/IV | 23 12.2% | 8/25.8% | 15/83.3% | <0.001 |
NEC | 2/4.1% | - | 2/11.1% | NA |
Outcomes | B | S.E | p Value | Odds Ratio | 95% CI | |
---|---|---|---|---|---|---|
Lower | Upper | |||||
Neonatal death | 1.79 | 1.19 | 0.13 | 6.00 | 0.574 | 62.69 |
Bronchopulmonary dysplasia | 3.40 | 1.12 | 0.002 | 30.00 | 3.33 | 269.7 |
IVH grades I/II | −3.135 | 0.85 | <0.001 | 0.043 | 0.008 | 0.23 |
IVH grades III/IV | 2.665 | 0.754 | <0.001 | 14.37 | 3.280 | 63.0 |
Variable | Total (n = 49) | Case Group (Delivery According to UA) (n = 31) | Control Group (Delivery According to DV) (n = 18) | p Value |
---|---|---|---|---|
GA on delivery | 29 (2) | 29 (2) | 28 (1) | 0.23 |
Abnormal CTG | 6/12.2% | 1/3.2% | 5/27.8% | 0.02 |
Abnormal BPP | 4/8.2% | 1/3.2% | 3/16.7% | 0.13 |
Outcomes | B | S.E | p Value | Adjusted Odds Ratio | 95% CI | |
---|---|---|---|---|---|---|
Lower | Upper | |||||
Bronchopulmonary dysplasia | 3.40 | 1.15 | 0.003 | 30.24 | 3.126 | 292.6 |
IVH I/II | −3.836 | 1.113 | 0.001 | 0.02 | 0.002 | 0.191 |
IVH III/IV | 3.186 | 0.968 | 0.001 | 24.195 | 3.628 | 161.350 |
Outcomes | B | S.E | p Value | Adjusted Odds Ratio | 95% CI | |
---|---|---|---|---|---|---|
Lower | Upper | |||||
Bronchopulmonary dysplasia | 3.14 | 1.19 | 0.008 | 23.16 | 2.25 | 238.4 |
IVH I/II | −4.820 | 1.49 | 0.001 | 0.08 | 0.00 | 0.150 |
IVH III/IV | 4.253 | 1.36 | 0.002 | 70.29 | 4.86 | 1016.64 |
Parameters | Total (n = 120) | Case Group [Delivery at the Advent of the UA-AEDF] (n = 76) | Control Group- [Delivery Delayed Until UA-REDF] (n = 44) | p Value |
---|---|---|---|---|
IVH I/II | 29/24.2% | 8/10.5% | 21/47.7% | <0.0001 |
IVH III/IV | 2/1.7% | - | 2/4.5% | NA |
Outcomes | p Value | Odds Ratio | 95% CI | |
---|---|---|---|---|
Lower | Upper | |||
IVH grades I/II | <0.001 | 7.76 | 3.02 | 19.9 |
Models | p Value | Adjusted Odds Ratio | 95% CI | |
---|---|---|---|---|
Lower | Upper | |||
Model 1 | <0.001 | 14.37 | 4.32 | 47.76 |
Model 2 | <0.001 | 14.49 | 4.36 | 48.14 |
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Bujorescu, D.-L.; Ratiu, A.; Citu, C.; Gorun, F.; Gorun, O.M.; Crisan, D.C.; Cozlac, A.-R.; Chiorean-Cojocaru, I.; Tunescu, M.; Popa, Z.L.; et al. Appropriate Delivery Timing in Fetuses with Fetal Growth Restriction to Reduce Neonatal Complications: A Case—Control Study in Romania. J. Pers. Med. 2023, 13, 645. https://doi.org/10.3390/jpm13040645
Bujorescu D-L, Ratiu A, Citu C, Gorun F, Gorun OM, Crisan DC, Cozlac A-R, Chiorean-Cojocaru I, Tunescu M, Popa ZL, et al. Appropriate Delivery Timing in Fetuses with Fetal Growth Restriction to Reduce Neonatal Complications: A Case—Control Study in Romania. Journal of Personalized Medicine. 2023; 13(4):645. https://doi.org/10.3390/jpm13040645
Chicago/Turabian StyleBujorescu, Daniela-Loredana, Adrian Ratiu, Cosmin Citu, Florin Gorun, Oana Maria Gorun, Doru Ciprian Crisan, Alina-Ramona Cozlac, Ioana Chiorean-Cojocaru, Mihaela Tunescu, Zoran Laurentiu Popa, and et al. 2023. "Appropriate Delivery Timing in Fetuses with Fetal Growth Restriction to Reduce Neonatal Complications: A Case—Control Study in Romania" Journal of Personalized Medicine 13, no. 4: 645. https://doi.org/10.3390/jpm13040645
APA StyleBujorescu, D. -L., Ratiu, A., Citu, C., Gorun, F., Gorun, O. M., Crisan, D. C., Cozlac, A. -R., Chiorean-Cojocaru, I., Tunescu, M., Popa, Z. L., Folescu, R., & Motoc, A. (2023). Appropriate Delivery Timing in Fetuses with Fetal Growth Restriction to Reduce Neonatal Complications: A Case—Control Study in Romania. Journal of Personalized Medicine, 13(4), 645. https://doi.org/10.3390/jpm13040645