DIFFERENCE BETWEEN MATERNAL RISK FACTORS FOR FETAL GROWTH RESTRICTION AND SMALL FOR GESTATIONAL AGE

Objective: This study aimed to compare the maternal gestational risks of insufficient fetal growth (IFG), including small for gestational age (SGA) and fetal growth restriction (FGR). Materials and methods: This retrospective cohort study was conducted at Perinatal center of N.A. Semashko Republican Clinical Hospital between 2018 and 2023. The study included 611 women with IFG, including 435 with FGR and 176 with SGA. The discriminators of FGR and SGA were studied. Statistical analysis was performed using Statistica 12.0 and Microsoft Excel 2007, and CHAID analysis was conducted using the Classification Trees module. Results: Potential causes of IFG were hypertensive disorders during pregnancy (41.74%), including preeclampsia (PE) (25.21%), severe (22.59%) or moderate (2.62%), gestational hypertension (GAH) (8.67%), chronic arterial hypertension (CAH) (7.86%), and gestational diabetes mellitus (GDM) (12.77%). The cause of IFG was unknown in 45.49% of women. FGR was more likely to be associated with PE of unknown cause (OR=1.94); SGA was associated with GDM (OR=8.76), GAH (OR=4.38), and CAH (OR=3.93). Prematurity is not obligatory for IFG (24.22%) but is typical for FGR (34.02%). Preterm delivery was associated with severe PE (OR=14.89) and CAH (OR=2.43). The rate of cesarean section for IFG was 55.16% and was associated with FGR (OR=2.95), PE or CAH in FGR, GAH (OR=12.00), and an unknown cause (OR=2.05) in SGA infants. The incidence of iatrogenic prematurity in IFG due to FGR was 86.48 %. Low birth weight (LBW) was more common in the FGR group (OR=6.38). Conclusion: The FGR and SGA differ in terms of risk factors. The causes of IFG are associated with the risk of iatrogenic prematurity and LBW. Prevention of gestational complications of cardiometabolic origin (hypertensive disorders and GDM) is a measure for preventing IFG. The association of PE with FGR, but not with SGA, confirms the similarity of their pathogenesis and the impossibility of uniform prevention of both IFG variants. © A group of authors, 2024.