COMPARISON BETWEEN DIAGNOSTIC CRITERIA FOR FETAL GROWTH RESTRICTION BASED ON PERINATAL OUTCOMES

• Grant number: 25/01473-7
• Support Opportunities: Scholarships in Brazil - Scientific Initiation
• Start date: April 01, 2025
• End date: March 31, 2026
• Field of knowledge: Health Sciences - Medicine
• Principal Investigator: Ana Carolina Rabachini Caetano
• Grantee: Lara Dariolli Rossi
• Host Institution: Escola Paulista de Medicina (EPM). Universidade Federal de São Paulo (UNIFESP). Campus São Paulo. São Paulo , SP, Brazil

Abstract

Fetal growth restriction (FGR) occurs when the fetus does not reach its growth and development potential in the uterus, compromising the perinatal prognosis. The greatest challenge is distinguishing between fetuses that are constitutionally small and those that are truly restricted with a higher risk of adverse neonatal outcomes. Thus, the objective of this project is to evaluate the best diagnostic criterion for growth restriction that can predict adverse neonatal outcomes in pregnant women attended at the Escola Paulista de Medicina - UNIFESP. To achieve this, patients who had fetuses with an estimated fetal weight below the 10th percentile in singleton pregnancies, with delivery between 26 and 40 weeks, will be classified into fetuses with growth restriction and small-for-gestational-age fetuses, based on diagnostic criteria from expert consensus following the Delphi methodology and criteria published by the University of Barcelona. The perinatal outcome will be compared between groups. The percentage of restricted fetuses with unfavorable outcomes will be analyzed, including: elective prematurity, elective or emergency cesarean section due to fetal distress, admission to a neonatal intensive care unit, umbilical cord pH < 7.10, Apgar < 7 at the fifth minute, respiratory distress syndrome, intraventricular hemorrhage, presence of seizures, and intra-hospital fetal or neonatal death. After data collection, we will characterize the relative frequency distribution of qualitative variables through the Two-Proportion Z-Test. For group comparison, the Chi-Square test will be used, and when analyzing quantitative factors by mean and standard deviation, the T-Student test will be applied. If the parametric T-Student test is not applicable, the non-parametric Mann-Whitney test will be used. Confidence intervals for the means will be constructed with 95% statistical confidence. The direct comparison between these protocols will allow the identification of convergences and divergences in their criteria, as well as the evaluation of their predictive capacity for adverse neonatal outcomes.