Abstract

Introduction Intrauterine Growth Restriction (IUGR) occurs in about 10% of pregnancies and it is considered the most common and complex problem in modern obstetrics. The aim of this study was to investigate the relationship between first trimester biochemical (PAPP-A and free b-hCG) and ultrasound (Crown-rump length; CRL and Nuchal translucency; NT) screening tests and the risk of IUGR. Methods This was a retrospective cohort study of 16788 singleton pregnancies attending between January 2009 and December 2016. Sample was divided in percentiles by weight at birth and women were assigned to two groups: Normal pregnancy group (birth weight at or above the 10th percentile for gestational age) and SGA group. The SGA group was classified into three subgroups per birth weight below the 10th, 5th and 3rd percentile for gestational age. Results In SGA pregnancies and severe IUGR, the median PAPP-A MoM, free β-hCG MoM and CRL measurements were significantly lower than that in the normal group, but the median NT was not statistically significantly different from normal. A multivariate model analysis was performed with the method of selecting successive steps, obtaining the variables able to predict SGA and severe IUGR. Discussion After analyzing our results, we ascertained that some variables were protective, and others were risk factors for SGA, however a multivariate model established to predict SGA indicates that these were not good predictors of SGA (AUC = 0.65). When analyzing the data by comparing the normal group to severe IUGR, we conclude that the model including MoM PAPP-A, MoM β-hCG, CRL, maternal weight, smoker status, hypertension conditions and parity, was a good model for predicting the risk of IUGR severe (AUC 0.703).

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