- •Of note, ≥50th percentile fetal growth decline is associated with late fetal growth restrictions.
- •Of note, ≥50th percentile fetal growth decline is strongly associated with perinatal mortality.
- •The risk of fetal demise is related to the magnitude of decline and not the rate of decline.
- •Neonatal morbidity is not significantly associated with fetal growth decline.
- •The magnitude of fetal growth decline is important when determining the timing of birth.
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- Defining normal and abnormal fetal growth: promises and challenges.Am J Obstet Gynecol. 2010; 202: 522-528
- Placental pathology in early-onset and late-onset fetal growth restriction.Fetal Diagn Ther. 2014; 36: 117-128
- Consensus definition of fetal growth restriction: a Delphi procedure.Ultrasound Obstet Gynecol. 2016; 48: 333-339
- Society for Maternal-Fetal Medicine, Martins JG, Biggio JR, Abuhamad A. Society for Maternal-Fetal Medicine Consult Series #52: diagnosis and management of fetal growth restriction: (replaces Clinical Guideline Number 3, April 2012).Am J Obstet Gynecol. 2020; 223: B2-17
- ISUOG Practice Guidelines: diagnosis and management of small-for-gestational-age fetus and fetal growth restriction.Ultrasound Obstet Gynecol. 2020; 56: 298-312
- FIGO (International Federation of Gynecology and Obstetrics) initiative on fetal growth: best practice advice for screening, diagnosis, and management of fetal growth restriction.Int J Gynaecol Obstet. 2021; 152: 3-57
- Small-for-gestational-age infants among uncomplicated pregnancies at term: a secondary analysis of 9 Maternal-Fetal Medicine Units Network studies.Am J Obstet Gynecol. 2016; 215 (e1–7): 628
- Term small-for-gestational-age infants from low-risk women are at significantly greater risk of adverse neonatal outcomes.Am J Obstet Gynecol. 2018; 218 (e1–9): 525
- Birth-weight centiles and the risk of serious adverse neonatal outcomes at term.J Perinat Med. 2018; 46: 1048-1056
- Impact of cerebral redistribution on neurodevelopmental outcome in small-for-gestational-age or growth-restricted babies: a systematic review.Ultrasound Obstet Gynecol. 2015; 46: 398-404
- Estimation of fetal weight with the use of head, body, and femur measurements–a prospective study.Am J Obstet Gynecol. 1985; 151: 333-337
- Ultrasonic fetal measurements: new Australian standards for the new millennium.Aust N Z J Obstet Gynaecol. 2000; 40: 297-302
- Reference centiles for the middle cerebral artery and umbilical artery pulsatility index and cerebro-placental ratio from a low-risk population - a Generalised Additive Model for Location, Shape and Scale (gamlss) approach.J Matern Fetal Neonatal Med. 2019; 32: 2338-2345
- New Australian birthweight centiles.Med J Aust. 2020; 213: 79-85
- Information theory and an extension of the maximum likelihood principle.in: Kotz S Johnson NL Breakthroughs in statistics. Springer, New York, NY1992: 610-624
R Core Team. R: a language and environment for statistical computing. R Foundation for Statistical Computing. 2020. Available at: http://www.r-project.org. Accessed Aug. 1st, 2022.
- Perinatal outcome of appropriate-weight fetuses with decelerating growth.J Matern Fetal Neonatal Med. 2021; 34: 3362-3369
- Reduced fetal growth velocity precedes antepartum fetal death.Ultrasound Obstet Gynecol. 2021; 57: 942-952
- Fetal growth rate and adverse perinatal events.Ultrasound Obstet Gynecol. 1999; 13: 86-89
- US evaluation of fetal growth: prediction of neonatal outcomes.Radiology. 2002; 223: 153-161
- Is obstetric and neonatal outcome worse in fetuses who fail to reach their own growth potential?.Br J Obstet Gynaecol. 1992; 99: 452-454
- Are babies of normal birth weight who fail to reach their growth potential as diagnosed by ultrasound at increased risk?.Ultrasound Obstet Gynecol. 1995; 5: 114-118
- Early adverse perinatal complications in preterm growth-restricted fetuses.Aust N Z J Obstet Gynaecol. 2011; 51: 204-209
- Prediction of perinatal morbidity at term in small fetuses: comparison of fetal growth and Doppler ultrasound.Br J Obstet Gynaecol. 1994; 101: 422-427
- The role of growth trajectories in classifying fetal growth restriction.Obstet Gynecol. 2013; 122: 248-254
- Longitudinal growth assessment for prediction of adverse perinatal outcome in fetuses suspected to be small-for-gestational age.Ultrasound Obstet Gynecol. 2018; 52: 325-331
- Longitudinal ultrasound measures of fetal growth and offspring outcomes.Curr Epidemiol Rep. 2017; 4: 98-105
- Ultrasound prediction of adverse perinatal outcome at diagnosis of late-onset fetal growth restriction.Ultrasound Obstet Gynecol. 2022; 59: 342-349
Unterscheider J, Daly S, Geary MP, et al. Optimizing the definition of intrauterine growth restriction: the multicenter prospective PORTO Study.Am J Obstet Gynecol 2013;208:290. e1–6.
- Identification of fetal growth retardation: comparison of Doppler waveform indices and serial ultrasound measurements of abdominal circumference and fetal weight.Obstet Gynecol. 1993; 82: 230-236
- Prediction of birth weight by ultrasound-estimated fetal weight: a comparison between single and repeated estimates.Eur J Obstet Gynecol Reprod Biol. 1995; 60: 37-40
- Screening for fetal growth restriction with universal third trimester ultrasonography in nulliparous women in the Pregnancy Outcome Prediction (POP) study: a prospective cohort study.Lancet. 2015; 386: 2089-2097
- Fetal growth velocity and body proportion in the assessment of growth.Am J Obstet Gynecol. 2018; 218 (e1): S700-S711
- Placental insufficiency in fetuses that slow in growth but are born appropriate for gestational age: a prospective longitudinal study.PLoS One. 2016; 11e0142788
- Reduced growth velocity across the third trimester is associated with placental insufficiency in fetuses born at a normal birthweight: a prospective cohort study.BMC Med. 2017; 15: 164
- Reduced growth velocity from the mid-trimester is associated with placental insufficiency in fetuses born at a normal birthweight.BMC Med. 2020; 18: 395
- Interval between fetal measurements in predicting growth restriction.Obstet Gynecol. 2001; 97: 499-504
M.L.L. and C.E.H.H. are funded by the Elsass Foundation (20-3-0573). S.K. is supported by the Mater Foundation and receives funding from the Australian Medical Research Future Fund and the National Health and Medical Research Council. None of the funding parties had any involvement in the study.
The authors report no conflict of interest.
The findings in this manuscript were presented at the 32nd World Congress on Ultrasound in Obstetrics and Gynecology, presented by the International Society of Ultrasound in Obstetrics and Gynecology, London, United Kingdom, September 16–18, 2022.
Cite this article as: Larsen ML, Schreiber V, Krebs L, et al. The magnitude rather than the rate of decline in fetal growth is a stronger risk factor for perinatal mortality in term infants. Am J Obstet Gynecol MFM 2022;XX:x.ex–x.ex.