Does the antenatal detection of fetal growth restriction (FGR) have a prognostic value for mortality and short-term morbidity for very preterm infants? Results from the MOSAIC cohort.
OBJECTIVE
We investigated the impact of antenatal diagnosis of fetal growth restriction (FGR) on the risks of mortality and morbidity for very preterm infants given actual birthweight percentiles.


METHODS
Data on 4608 live born infants 24-31 weeks of gestational age (GA) in 10 European regions in 2003 were used to compare in-hospital mortality, bronchopulmonary dysplasia (BPD) and severe neurological morbidity by birthweight percentiles and antenatal diagnosis of FGR. Other covariates were GA, sex, multiplicity, maternal complications, antenatal corticosteroids, birth in a level III center and region.


RESULTS
Sixteen percent (n = 728) of all infants and 72%, 30% and 6%, respectively, of those with birthweight percentiles <10th, 10th-24th and ≥25th had an antenatal diagnosis of FGR. After adjustment for clinical factors, antenatal diagnosis of FGR was not associated with mortality for infants with a birthweight ≥10th percentile (OR [95% CI]: 0.9 [0.5-1.9] and 1.0 [0.6-1.8] for birthweights between the 10th-24th percentile and ≥25th percentile, respectively), but infants with a birthweight <10th percentile had higher mortality (OR [95% CI]: 2.4 [1.0-5.8]). No association was observed at any birthweight percentile with BPD or severe neurological morbidity.


CONCLUSIONS
Antenatal diagnosis of FGR did not influence risks of mortality or morbidity when birthweight was ≥10th percentile; however, mortality risk was higher in antenatally detected infants with birthweight below the <10th percentile.
a INSERM, Obstetrical, Perinatal and Pediatric Epidemiology Research Team, Center for Epidemiology and Biostatistics (U1153), Paris-Descartes University , Paris , France .|b Service de Médecine et Réanimation néonatales de Port-Royal, Hôpitaux Universitaires Paris Centre Site Cochin, Université Paris V René Descartes and Assistance Publique Hôpitaux de Paris , Paris , France .
Mayass
M
El Ayoubi
b Service de Médecine et Réanimation néonatales de Port-Royal, Hôpitaux Universitaires Paris Centre Site Cochin, Université Paris V René Descartes and Assistance Publique Hôpitaux de Paris , Paris , France .
Pierre-Henri
PH
Jarreau
c Department of Neonatology , Antwerp University Hospital, University of Antwerp and Study Centre for Perinatal Epidemiology Flanders , Belgium , and.
Patrick
P
Van Reempts
d Research Unit of Perinatal Epidemiology , Bambino Gesù Children's Hospital, Viale Ferdinando Baldelli 41 , Roma , Italy.
Marina
M
Cuttini
a INSERM, Obstetrical, Perinatal and Pediatric Epidemiology Research Team, Center for Epidemiology and Biostatistics (U1153), Paris-Descartes University , Paris , France .
Monique
M
Kaminski
a INSERM, Obstetrical, Perinatal and Pediatric Epidemiology Research Team, Center for Epidemiology and Biostatistics (U1153), Paris-Descartes University , Paris , France .
Jennifer
J
Zeitlin
D015331:Cohort Studies; D005060:Europe / Q000453:epidemiology; D005260:Female; D005317:Fetal Growth Retardation / Q000175:diagnosis*; D017052:Hospital Mortality; D006801:Humans; D007223:Infant; D007226:Infant Mortality; D007231:Infant, Newborn; D007234:Infant, Premature; D019102:Infant, Very Low Birth Weight; D008297:Male; D011247:Pregnancy; D011296:Prenatal Diagnosis; D011379:Prognosis
Birthweight percentile; bronchopulmonary dysplasia; fetal growth restriction; in-hospital mortality; preterm infants; severe neurological morbidity