OC14.08: Risk factors and association of short interval from diagnosis to delivery in preterm fetal growth restriction

To identify risk factors for short (i.e. <7 days) time-to-delivery interval in fetuses suspect of preterm fetal growth restriction (FGR) secondary to uteroplacental insufficiency, in order to facilitate timing of corticosteroids for fetal maturation and counselling. Secondary analysis of data combined from two multicentre studies conducted across European perinatal centres: The Trial of Umbilical and Fetal Flow in Europe randomised controlled trial (TRUFFLE RCT) and the prospective TRUFFLE2 feasibility study. The TRUFFLE RCT included women with FGR at 26-32 weeks and randomised abnormal ductus venosus PI and computerised cardiotocography (cCTG) versus only cCTG to decide when to deliver the baby. The TRUFFLE2 included women at 32 – 36 weeks with suspected FGR and collected monitoring parameters longitudinally. The endpoint of interest for the study was interval from inclusion to delivery <7 days. The parameters that were associated with such endpoint were assessed first by univariate analysis, then by multivariate logistic regression analysis. The study cohort consisted of 1359 women, of whom 503 from the TRUFFLE RCT and 856 from the TRUFFLE 2 feasibility study. Gestational age at delivery, UCR, the severity of growth restriction and pre-eclampsia all were associated with short inclusion-to-delivery interval. The area under the curve (AUC) of a receiver characteristics graph (ROC) was 0.83 (95% interval 0.80-0.85). The proposed model for the prediction of interval from diagnosis to delivery <7 days has fairly good accuracy and could potentially be used for timing steroids administration and counselling at the time FGR is diagnosed.