Factors associated with abnormal fetal growth in preterm and term stillbirths: a case-control study

• Grant number: 23/12123-1
• Support Opportunities: Scholarships abroad - Research Internship - Post-doctor
• Start date: November 01, 2023
• End date: February 29, 2024
• Field of knowledge: Health Sciences - Collective Health - Epidemiology
• Principal Investigator: Marcia Furquim de Almeida
• Grantee: Lays Janaina Prazeres Marques
• Supervisor: Enny Paixão Cruz
• Host Institution: Faculdade de Saúde Pública (FSP). Universidade de São Paulo (USP). São Paulo , SP, Brazil
• Institution abroad: London School of Hygiene and Tropical Medicine, England
• Associated to the scholarship: 22/13271-1 - Factors associated with fetal vulnerability and to fetal death, BP.PD

Abstract

Abnormal fetal growth and prematurity are responsible for the majority of stillbirths in the municipality of São Paulo. However, there are gaps in the knowledge of these aspects related to the occurrence of stillbirths, making it difficult to implement more effective interventions to reduce stillbirths. Studies that analyze the characteristics of fetal vulnerability together, such as changes in fetal growth and prematurity, represent recent and innovative proposals. The assessment of risk factors for abnormal fetal growth in stillbirths represents one of the objectives of the interdisciplinary thematic project "Fetal mortality: challenges of knowledge and intervention (FetRisks - FAPESP Process: 16/07765-0)", of which this project is linked. The FetRisks project has a large volume of data that needs to be processed and interpreted based on a theoretical-conceptual model of risk factors associated with fetal vulnerability and on the construction of a directed acyclic graph (DAG) to identify confounding, and mediating factors. The complexity of this big data study requires adequate expertise to carry out epidemiological analyses. In this sense, the research internship abroad would contribute to acquiring knowledge about new analysis techniques and expertise in perinatal epidemiology studies. The LSHTM is an associated institution of the FetRisks project. The expertise of Dr. Enny Paixão from LSHTM in studies of perinatal epidemiology and research with large databases would bring gains to the project. The expected objectives during the Research Internship Abroad proposed for this project aim to 1) Build the theoretical model of variables associated with alteration in fetal growth according to gestational age (<37 weeks and e37 weeks), based on the FetRisks project variables; 3) Apply this model to the elaboration of the DAG, identifying possible confounding, adjustment, mediation, and collision variables; 3) Classify the fetal growth pattern of stillbirths (cases) and live births (controls) based on the expanded INTERGROWTH-21st parameters and identify the types of newborns; 4) Perform analyzes based on the logistic regression model, calculating the Odds Ratios; 5) Write a scientific paper with the results of the case-control study, extending the collaboration of Dr. Enny Paixão (LSHTM) to participate in discussions with Dr. Marcia Furquim de Almeida (FSP-USP) and other researchers from the FetRisks project. (AU)