On the issue of risk factors for insufficient fetal growth

Objective. To study the clinical and anamnestic features in patients with various forms of fetal stunting to determine the risk factors for the development of this pregnancy complication. Material and methods. The study included 329 patients, who, depending on pregnancy outcomes, were divided into 3 groups: The 1st group (main group) included 165 women whose pregnancy was complicated by insufficient fetal growth (IFG). The main group was divided into 2 subgroups: 1a — 72 patients, whose pregnancy was complicated by the development of a fetus of low gestational age (LGA), 1b — 93 patients, whose pregnancy was complicated by fetal growth retardation. The 2nd group (comparison) included 164 patients whose pregnancy ended with the birth of a live full-term baby without signs of insufficient growth. The somatic and obstetric anamnesis and the course of pregnancy were studied in all patients. Results. It was shown that patients younger than 20 years of age were more likely to occur in the SGA and FGR subgroups (odds ratio — OR 5.8; 95% confidence interval — CI 1.450—23.039; p=0.010 and OR 4.4; 95% CI 1.102—17.322; p=0.039, respectively). An analysis of the maternal history showed that preterm birth was more common in the SGA group than in the comparison group (OR 2.8; 95% CI 1.077—7.165; p=0.038). Insufficient fetal growth in the previous pregnancy was more common in women of the main group and increased the chance of this pregnancy complication in the present pregnancy: 4.3 times (OR 4.3; 95% CI 1.282—14.330; p=0.016) for FGR and 3.7 times (OR 3.7; 95% CI 0.994—13.306; p=0.072) for a fetus of low weight for this gestational age. Uterine scarring was more common in patients of the SGA group than in the comparison group (OR 2.4; 95% CI 1.143—4.867; p=0.029). Early toxicosis and gestational diabetes mellitus were more common in patients in the FGR group than in the comparison group (OR 3.1; 95% CI 1.622—6.011; p<0.001 and OR 2.1; 95% CI 1.181—3.829; p=0.014). Conclusion. The study identified new risk factors for breast undergrowth. It is necessary to take into account the patient’s age, the presence of a scar on the uterus, premature birth, insufficient fetal growth in a previous pregnancy, early toxicosis, and gestational diabetes mellitus in order to timely assess the risk of insufficient fetal growth.