Kamphof, H. (Hester) (2019) Does the newly developed definition for growth restriction in the newborn identify newborns at risk better than the definition of Small for Gestational Age. thesis, Medicine.
Full text available on request.Abstract
Fetal growth restriction (FGR) refers to a condition where the fetus fails to reach its intrinsic intra-uterine growth potential, regardless of its birthweight. Growth restricted newborns are at risk for perinatal morbidity and mortality but in many cases the growth restriction is not picked up during pregnancy or it is not recognized after birth. It is common practice to identify newborns with a growth restriction by using the cut-off of a birthweight below the tenth percentile of a growth curve (p10). These children are known as small for gestational age (SGA). This group is however diluted by many constitutionally small but healthy newborns. Recently a new consensus-based definition was developed for growth restriction in the newborn (GRN). This definition includes more factors than only birthweight namely the length and the head circumference at birth, maternal illnesses during the pregnancy that are a risk factor for intrauterine growth restriction and the prenatal diagnosis of FGR diagnosed by ultrasound. We tested if this new definition performs better at identifying newborns at risk than the cut-off for SGA. Maternal factors, information about the pregnancy and delivery, newborns characteristics, neonatal outcomes and placenta pathology were all taken into account. 237 women with singleton pregnancies who delivered their baby in the UMCG were included. They were divided into two groups, 173 were in the GRN-and-SGA group and 64 were in the SGAnot-GRN group. We concluded that although the new definition of GRN is more specific than using SGA, both groups still had a higher risk of adverse outcomes than the general population. In the SGA group 29.7% experienced at least one adverse outcome and in the FGR group this was 42.2% (p = .079). Therefore, the new definition of GRN is not yet suitable for practical use.
| Item Type: | Thesis (Thesis) |
|---|---|
| Supervisor name: | Faculty supervisor: and Gordijn, Dr. S. J. and Second supervisor: and Kooi, Dr. E. M. W. and Institution: University Medical Centre Groningen Department: |
| Faculty: | Medical Sciences |
| Date Deposited: | 25 Jun 2020 11:03 |
| Last Modified: | 25 Jun 2020 11:03 |
| URI: | https://umcg.studenttheses.ub.rug.nl/id/eprint/2350 |
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