title: Is fetal growth restriction associated with a more severe maternal phenotype in the setting of early onset pre-eclampsia? A retrospective study.
abstract: BACKGROUND
  Both pre-eclampsia and fetal growth restriction are thought to result from abnormal placental implantation in early pregnancy. Consistent with this shared pathophysiology, it is not uncommon to see growth restriction further confound the course of pre-eclampsia and vice versa. It has been previously suggested that superimposed growth restriction is associated with a more severe pre-eclamptic phenotype, however this has not been a consistent finding. Therefore, we set out to determine whether the presence of fetal growth restriction among women with severe early-onset pre-eclampsia was associated with more severe maternal disease compared to those without a growth-restricted fetus.
  
  
  RESULTS
  We undertook a retrospective cohort study of women presenting to a tertiary hospital with severe early-onset pre-eclampsia (<34 weeks' gestation) between 2005-2009. We collected clinical data, including severity of pre-eclampsia, maternal and neonatal outcomes. Of 176 cases of severe pre-eclampsia, 39% (n = 68) were further complicated by fetal growth restriction. However, no significant difference was seen in relation to the severity of pre-eclampsia between those with or without a growth-restricted baby. The presence of concomitant growth restriction was however associated with a significantly increased risk of stillbirth (p = 0.003) and total perinatal mortality (p = 0.02).
  
  
  CONCLUSIONS
  The presence of fetal growth restriction among women with severe early-onset pre-eclampsia is not associated with increased severity of maternal disease. However the incidence of stillbirth and perinatal death is significantly increased in this sub-population.
authors: Department of Obstetrics and Gynaecology, Monash Medical Centre, Clayton, Victoria, Australia.
authors: Jane
authors: J
authors: Weiler
authors: Stephen
authors: S
authors: Tong
authors: Kirsten R
authors: KR
authors: Palmer
mesh_terms: D000328:Adult; D005260:Female; D005317:Fetal Growth Retardation / Q000453:epidemiology / Q000209:etiology*; D006801:Humans; D009035:Mothers; D054238:Perinatal Mortality; D010641:Phenotype; D011225:Pre-Eclampsia / Q000453:epidemiology; D011247:Pregnancy; D012189:Retrospective Studies; D012720:Severity of Illness Index; D050497:Stillbirth