Predictive value of fetal growth trajectory from 20 weeks of gestation onwards for severe adverse perinatal outcomes in low‐risk population: secondary analysis of IRIS study

This study aimed to investigate the predictive value of a slow fetal growth trajectory between 18+0 to 23+6 weeks' gestation and 32-36 weeks' gestation in a large, low-risk population. The researchers analyzed ultrasound data from routine scans and assessed whether a slow fetal growth trajectory was associated with severe adverse perinatal outcomes (SAPO). The results showed that stand-alone declines in AC or EFW percentiles and ACGV below the 10th percentile were not associated with increased odds of SAPO. However, EFW below the 10th percentile and a decline of more than 20 percentiles in EFW were associated with increased SAPO rates. Combining AC or EFW below the 10th percentile with ACGV below the 10th percentile also increased the odds of SAPO, particularly if the newborn was small for gestational age (SGA) at birth. The study concluded that slow fetal growth trajectory alone might not accurately distinguish between growth-restricted fetuses and constitutionally small fetuses, suggesting the need for new approaches to detect placental insufficiency.