Development of a prognostic model for pregnancy outcome in extremely early onset fetal growth restriction: A retrospective cohort study.

Development of a prognostic model for pregnancy outcome in extremely early onset fetal growth restriction: A retrospective cohort study. | Authorea try { document.documentElement.classList.add('js'); } catch (e) { } var _gaq = _gaq || []; _gaq.push(['_setAccount', 'G-8VDV14Y67G']); _gaq.push(['_trackPageview']); (function() { var ga = document.createElement('script'); ga.type = 'text/javascript'; ga.async = true; ga.src = ('https:' == document.location.protocol ? 'https://ssl' : 'http://www') + '.google-analytics.com/ga.js'; var s = document.getElementsByTagName('script')[0]; s.parentNode.insertBefore(ga, s); })(); Skip to main content Preprints Collections Wiley Open Research IET Open Research Ecological Society of Japan All Collections About About Authorea FAQs Contact Us Quick Search anywhere Search for preprint articles, keywords, etc. Search Search ADVANCED SEARCH SCROLL This is a preprint and has not been peer reviewed. Data may be preliminary. 22 July 2025 V1 Latest version Share on Development of a prognostic model for pregnancy outcome in extremely early onset fetal growth restriction: A retrospective cohort study. Authors : Lynne Warrander [email protected] , Emma Ingram , Alexander Heazell 0000-0002-4303-7845 , and Edward Johnstone Authors Info & Affiliations https://doi.org/10.22541/au.175318757.75519862/v1 210 views 257 downloads Contents Abstract Supplementary Material Information & Authors Metrics & Citations View Options References Figures Tables Media Share Abstract Objective To develop a prognostic model to predict pregnancy outcome in extremely early-onset fetal growth restriction (eFGR) using maternal characteristics, ultrasound parameters, and longitudinal biometry data. Design Retrospective cohort study. Setting Specialist fetal growth clinic at a tertiary centre and satellite clinics in the UK. Population Singleton pregnancies diagnosed with eFGR between 2009 and 2019, meeting Delphi consensus criteria and delivered before 33+0 weeks’ gestation (n = 182). Methods Maternal and ultrasound data were analysed to identify factors associated with fetal death in utero (FDIU) and perinatal mortality. Multivariable logistic regression and bootstrapped internal validation were used to develop and assess model performance. Longitudinal fetal growth trajectories were examined using multilevel mixed-effects linear regression. Main Outcome Measures Live birth to hospital discharge, FDIU, and neonatal or infant death. Results Gestational age at diagnosis, estimated fetal weight (EFW), umbilical artery end-diastolic flow (EDF), and uterine artery resistance index were significant predictors of FDIU (AUC 0.82). A model predicting overall perinatal death had moderate discrimination (AUC 0.75). Longitudinal analysis showed significantly slower fetal growth trajectories in pregnancies ending in FDIU, with early weight gain predictive of outcome. Conclusions A combination of gestational age, fetal biometry, and Doppler findings can predict adverse outcomes in eFGR. Longitudinal biometry adds prognostic value by enabling dynamic risk stratification. These findings support development of clinically applicable tools to inform counselling and management in eFGR. Supplementary Material File (paper 1 - figures.pptx) Download 15.17 MB File (paper 1 - tables to submit.docx) Download 37.20 KB File (paper 1 for submission.docx) Download 76.03 KB Information & Authors Information Version history V1 Version 1 22 July 2025 Copyright This work is licensed under a Non Exclusive No Reuse License. Keywords fetal diagnosis and therapy fetal medicine: perinatal diagnosis—ultrasound fetal medicine: uteroplacental insufficiency imaging pathology: perinatal statistics: epidemiological surveys Authors Affiliations Lynne Warrander [email protected] Manchester University NHS Foundation Trust View all articles by this author Emma Ingram Manchester University NHS Foundation Trust View all articles by this author Alexander Heazell 0000-0002-4303-7845 Manchester University NHS Foundation Trust View all articles by this author Edward Johnstone Manchester University NHS Foundation Trust View all articles by this author Metrics & Citations Metrics Article Usage 210 views 257 downloads .FvxKWukQNSOunydq8rnd { width: 100px; } Citations Download citation Lynne Warrander, Emma Ingram, Alexander Heazell, et al. Development of a prognostic model for pregnancy outcome in extremely early onset fetal growth restriction: A retrospective cohort study.. Authorea . 22 July 2025. 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