Fetal growth restriction and the risk of perinatal mortality–case studies from the multicentre PORTO study

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dc.contributor.author Unterscheider, Julia
dc.contributor.author O'Donoghue, Keelin
dc.contributor.author Daly, Sean
dc.contributor.author Geary, Michael P.
dc.contributor.author Kennelly, Mairead M.
dc.contributor.author McAuliffe, Fionnuala M.
dc.contributor.author Hunter, Alyson
dc.contributor.author Morrison, John J.
dc.contributor.author Burke, Gerard J.
dc.contributor.author Dicker, Patrick
dc.contributor.author Tully, Elizabeth C.
dc.contributor.author Malone, Fergal D.
dc.date.accessioned 2016-02-03T11:16:56Z
dc.date.available 2016-02-03T11:16:56Z
dc.date.issued 2014-02-11
dc.identifier.citation UNTERSCHEIDER, J., O’DONOGHUE, K., DALY, S., GEARY, M. P., KENNELLY, M. M., MCAULIFFE, F. M., HUNTER, A., MORRISON, J. J., BURKE, G., DICKER, P., TULLY, E. C. & MALONE, F. D. 2014. Fetal growth restriction and the risk of perinatal mortality–case studies from the multicentre PORTO study. BMC Pregnancy and Childbirth, 14:63, 1-6. http://dx.doi.org/10.1186/1471-2393-14-63 en
dc.identifier.volume 14 en
dc.identifier.startpage 1 en
dc.identifier.endpage 6 en
dc.identifier.issn 1471-2393
dc.identifier.uri http://hdl.handle.net/10468/2246
dc.identifier.doi 10.1186/1471-2393-14-63
dc.description.abstract Background: Intrauterine growth restriction (IUGR) is the single largest contributing factor to perinatal mortality in non-anomalous fetuses. Advances in antenatal and neonatal critical care have resulted in a reduction in neonatal deaths over the past decades, while stillbirth rates have remained unchanged. Antenatal detection rates of fetal growth failure are low, and these pregnancies carry a high risk of perinatal death. Methods: The Prospective Observational Trial to Optimize Paediatric Health in IUGR (PORTO) Study recruited 1,200 ultrasound-dated singleton IUGR pregnancies, defined as EFW <10th centile, between 24+0 and 36+6 weeks gestation. All recruited fetuses underwent serial sonographic assessment of fetal weight and multi-vessel Doppler studies until birth. Perinatal outcomes were recorded for all pregnancies. Case records of the perinatal deaths from this prospectively recruited IUGR cohort were reviewed, their pregnancy details and outcome were analysed descriptively and compared to the entire cohort. Results: Of 1,116 non-anomalous singleton infants with EFW <10th centile, 6 resulted in perinatal deaths including 3 stillbirths and 3 early neonatal deaths. Perinatal deaths occurred between 24+6 and 35+0 weeks gestation corresponding to birthweights ranging from 460 to 2260 grams. Perinatal deaths occurred more commonly in pregnancies with severe growth restriction (EFW <3rd centile) and associated abnormal Doppler findings resulting in earlier gestational ages at delivery and lower birthweights. All of the described pregnancies were complicated by either significant maternal comorbidities, e.g. hypertension, systemic lupus erythematosus (SLE) or diabetes, or poor obstetric histories, e.g. prior perinatal death, mid-trimester or recurrent pregnancy loss. Five of the 6 mortalities occurred in women of non-Irish ethnic backgrounds. All perinatal deaths showed abnormalities on placental histopathological evaluation. Conclusions: The PNMR in this cohort of prenatally identified IUGR cases was 5.4/1,000 and compares favourably to the overall national rate of 4.1/1,000 births, which can be attributed to increased surveillance and timely delivery. Despite antenatal recognition of IUGR and associated maternal risk factors, not all perinatal deaths can be prevented. en
dc.format.mimetype application/pdf en
dc.language.iso en en
dc.publisher BioMed Central Ltd. en
dc.rights © Unterscheider et al.; licensee BioMed Central Ltd. 2014. This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://​creativecommons.​org/​licenses/​by/​2.​0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver (http://​creativecommons.​org/​publicdomain/​zero/​1.​0/​) applies to the data made available in this article, unless otherwise stated. en
dc.rights.uri http://​creativecommons.​org/​licenses/​by/​2.​0 en
dc.subject Perinatal mortality en
dc.subject Antepartum stillbirth en
dc.subject Neonatal death en
dc.subject Intrauterine growth restriction en
dc.subject PORTO study en
dc.title Fetal growth restriction and the risk of perinatal mortality–case studies from the multicentre PORTO study en
dc.type Article (peer-reviewed) en
dc.internal.authorcontactother Keelin O’Donoghue, Department of Obstetrics and Gynaecology, University College Cork, Cork, Ireland. +353-21-490-3000 Email: K.Odonoghue@ucc.ie@ucc.ie en
dc.internal.availability Full text available en
dc.description.version Published Version en
dc.contributor.funder Health Research Board en
dc.contributor.funder Friends of the Rotunda Hospital, Dublin
dc.description.status Peer reviewed en
dc.identifier.journaltitle BMC Pregnancy and Childbirth en
dc.internal.IRISemailaddress k.odonoghue@ucc.ie en
dc.identifier.articleid 63


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© Unterscheider et al.; licensee BioMed Central Ltd. 2014. This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://​creativecommons.​org/​licenses/​by/​2.​0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver (http://​creativecommons.​org/​publicdomain/​zero/​1.​0/​) applies to the data made available in this article, unless otherwise stated. Except where otherwise noted, this item's license is described as © Unterscheider et al.; licensee BioMed Central Ltd. 2014. This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://​creativecommons.​org/​licenses/​by/​2.​0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver (http://​creativecommons.​org/​publicdomain/​zero/​1.​0/​) applies to the data made available in this article, unless otherwise stated.
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