Abstract
Due to the morbidity of mothers and newborns caused by fetal growth restriction (FGR) and preeclampsia, preventive measures should be taken, especially in women at high risk of developing these conditions. Many studies have been conducted on the prevention of FGR and preeclampsia in high-risk women, especially anticoagulants, aspirin, paravastatin, nitric oxide, microelements (L-arginine, folic acid, vitamins E and C, phytonutrients, vitamin D) and calcium.
 The aim is to improve perinatal consequences by preventing FGR in high-risk women.
 Materials and methods: A prospective study of 137 pregnant women in the period of 110–136 weeks was conducted at the Perinatal Center in Kyiv. Pregnant women were divided into 3 groups. The main group included 47 women at high risk of FGR who received therapy (low doses of aspirin, low molecular weight heparin (LMWH) and vitamin and micro elements drugs). The comparison group included 45 women who had a high risk of FGR but did not receive treatment. The control group consisted of 45 women who were not at risk of FGR. The frequency of FGR and placental dysfunction were analyzed as well as a fetal distress was analyzed ante- and intranatally.
 Results: Therapy with low doses of aspirin, LMWH and a complex preparation of vitamins and micro elements improves the course of pregnancy and gestational complications. In the main group FGR was detected in 8.5 %, in the comparison group – in 17.8 %, in the control group – 4.4 %. Placental dysfunction was detected in 13.3 % in the control group, and only 6.4 % in the main group that was close to the control group – 2.2 %. Similar tendencies were found for fetal distress ante- and intranatally.
 Conclusions: The proposed prophylactic measures can improve maternal outcomes by reducing the level of gestational complications in pregnant women with biochemical signs of risk of FGR development. In addition, these preventive measures can reduce the frequency of children births with growth restriction, which significantly reduces early neonatal and perinatal morbidity and mortality.
Highlights
Fetal growth restriction involves conditions under which the fetus does not reach its full growth potential
The study focuses on options for fetal growth restriction (FGR) prevention, which are closely related to the development of placental insufficiency and preeclampsia
The main group included 47 pregnant women with two or more of the above criteria for high risk of fetal growth restriction, who from the moment of inclusion in the study were prescribed a set of preventive measures: aspirin at a dose of 75 μg per day, low molecular weight heparin at a prophylactic dose, specified by the manufacturer and complex drug of vitamins and microelements
Summary
Fetal growth restriction involves conditions under which the fetus does not reach its full growth potential. In 2018, systematic reviews based on a meta-analysis at the research level [3] and a meta-analysis of individual patient data [4] from randomized trials of aspirin and other antiplatelet agents were published simultaneously, including 20,909 and 32,217 women, respectively. Both analyzes confirmed the available evidence that aspirin provides a slight reduction in the risk of FGR and GP (less than 5 or less than the 10th percentile) at birth (ana lysis of individual patient data, relative risk, 0.9–0.95 % confidence interval [CI] 0, 81–1.00)
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