Subsequent Pregnancy Outcome after First Pregnancy with Normotensive Early-Onset Intrauterine Growth Restriction at

Abstract

Objective. The aim of this study was to evaluate maternal and fetal outcome of the subsequent pregnancy of primiparous women with a history of early-onset intrauterine growth restriction (IUGR), prompting delivery before 34 weeks of gestation, without concomitant maternal hypertensive disease. Design. Retrospective cohort study. Setting. Tertiary center in the Netherlands. Population. Women with a normotensive first pregnancy complicated by early-onset severe IUGR, prompting delivery before 34 weeks of gestation. Methods. Reproductive follow-up data were recorded for 22 women with a normotensive first pregnancy complicated by early-onset severe IUGR before 34 weeks, referred to the University Medical Centre Utrecht, the Netherlands, between 1993 and 2005. Main Outcome Measures. Main outcome measures were recurrent IUGR, perinatal mortality, preterm delivery, preeclampsia (PE), pregnancy-induced hypertension, and other major obstetric complications, for example placental abruption. Results. Mean gestational age at delivery was 29.4 weeks for the index pregnancy compared to 36.4 weeks for the next pregnancy. IUGR recurred in six pregnancies (27.3%). Four subsequent pregnancies were complicated by hypertensive disorders. Perinatal mortality was 72.7% in the index pregnancy, compared to 13.6% in the second pregnancy. Overall, 11 women (54.5%) had an uneventful pregnancy. Conclusion. Women with first pregnancy early-onset IUGR, without concomitant maternal hypertensive disease, frequently develop severe perinatal complications in their subsequent pregnancy.