OP01.09: Socio‐demographic determinants and fetal sonographic measurements in patients with primary infection with cytomegalovirus during pregnancy

Abstract

Objectives: Infants with intrauterine growth restriction (IUGR) feature higher rates of mortality and postnatal morbidity. This study aimed to evaluate the perinatal and long-term neurodevelopmental outcome of IUGR fetuses compared to constitutionally small fetuses (small-for-gestational-age, SGA). Methods: Data of patients with IUGR and SGA who were examined at the Department of Obstetrics and Gynecology at the Medical University of Graz, Austria between 2003 and 2009 was analyzed retrospectively. Group assignment was based on birth weight, Doppler ultrasound, biophysical profile and placental morphology. Primary outcome parameters were neurodevelopmental as well as nutritional status at the age of two-years. Secondary outcomes were perinatal complications (periventricular leukomalacia, intraventricular hemorrhage, asphyxia and meconium obstruction). Results: 565 patients with IUGR and SGA were detected, from which 47 (8.3%) were excluded from further analysis due to major congenital malformations, twin pregnancies or incomplete data, resulting in a collective of 219 IUGR and 299 SGA fetuses. 157 patients did not follow the two-year neurodevelopmental evaluation leaving 146 IUGR and 215 SGA infants for that analysis. Fetuses with IUGR were delivered significantly earlier (35 vs. 38 weeks’ gestation, P < 0.0001) and had more perinatal complications (24.4% vs. 1.0%, OR 31.6, 95% CI 9.7–103.0). IUGR infants further had higher rates of mortality (8% vs. 1%; OR 8.3, 95% CI, 2.4–28.7), long-term neurodevelopmental impairment (24.7% vs. 5.6%; OR 5.5, 95% CI, 2.8–11.1) and dystrophy (21.2% vs. 7.4%, OR 3.4, 95% CI, 1.8–6.4). Conclusions: The study confirms a significantly increased risk for adverse outcome in IUGR infants in contrast to SGA babies, emphasizing the importance of prenatal identification of affected fetuses to allow adopted management.