Fetal Growth Restriction and Cesarean Delivery for Nonreassuring Fetal Heart Rate Tracing in the Late Preterm Period [15K

Abstract

INTRODUCTION: Women with fetal growth restriction (FGR) are often counseled about the fetus being unable to tolerate induction of labor and the risk for cesarean delivery (CD) for non-reassuring fetal heart tracing (NRFHT), especially in the late preterm period (between 34.0 and 36.6 weeks, LPP). The purpose of our study was to determine the association between FGR and CD for NRFHT in the LPP. METHODS: We performed a single-center case control study of women undergoing induction of labor (IOL) in the LPP between January 2010 and January 2017. Women were included if they underwent IOL between 34.0 and 36.6 weeks gestation of pregnancy with a non-anomalous, vertex, singleton gestation. Women with a previous CD and contraindications to IOL were excluded. Rates of FGR in women undergoing CD for NRFHT were compared to those undergoing CD for other indication or vaginal delivery. RESULTS: The odds of FGR were statistically significant for women who underwent a CD for NRFHT as compared to those having a vaginal delivery or CD for other indication (AOR 4.0; 95% CI 1.97-8.08) and (AOR 3.08; 95% CI 1.13-8.43). African American women had higher odds of IUGR than their white counterparts (AOR 2.65; 95% CI 1.46-4.82). CONCLUSION: Women with a diagnosis of FGR are significantly more likely to have a CD for NRFHT than a CD for other indication or VD in the LPP. This information should be included in counseling women who are undergoing an IOL and have a diagnosis of FGR in the LPP regardless of their indication for induction.