Fetal growth and body proportion in preeclampsia

Abstract

Objective To evaluate the effects of early- and late-onset preeclampsia on fetal growth and body proportion. Methods This was a population-based study based on records of 672,130 pregnancies from the Medical Birth Registry of Norway during 1967–1998. Women with a prior birth, multiple births, those without valid data on the last menstrual period or newborn’s crown–heel length, and chronic maternal disease were excluded. Results In newborns of women with preeclampsia, mean birth weight, crown–heel length, and ponderal index were 4.4%, 0.8%, and 2.6% lower than in births without preeclampsia, respectively. In preterm births, mean differences in birth weight ranged from −11% to −23% against near-equal birth weights in term births. Mean differences in crown–heel length and ponderal index ranged from −1% to −5% and from −5% to −10% before term, respectively. In late preeclampsia, rates of birth weight and crown–heel length above the 90th and 97.5th percentiles and ponderal index above the 97.5th percentile were slightly but significantly higher than in term births without preeclampsia (odds ratios = 1.1–1.5). However, infants born to mothers with preterm preeclampsia were less likely to be heavy, long, or with high ponderal index for gestational age (odds ratios = 0.4–0.6). Conclusion Our results support the hypothesis that preeclampsia is an etiologically heterogeneous disorder that occurs in at least two subsets, one with normal or enhanced placental function, and another involving placental dysfunction and fetal growth restriction, often with asymmetric fetal body proportion, reduced fetal length, and preterm delivery. In future studies, distinguishing between the two subtypes may be important.