Predicting Perinatal Mortality in Preterm Intrauterine Growth Restriction

We evaluated if maternal demographic and ultrasound parameters predict perinatal mortality in preterm intrauterine growth restriction (IUGR). Retrospective cohort study of preterm IUGR (delivery gestational age <35 weeks and birth weight <10th percentile for gestation). We excluded twins and fetuses with aneuploidy, intrauterine infection, or major congenital malformations. Information collected included maternal demographic and medical information, estimated fetal weight, oligohydramnios (amniotic fluid index <5), abnormal umbilical artery Dopplers (absent or reverse end-diastolic flow), and abnormal biophysical score (score <6). Our outcome was perinatal mortality, which was defined as in utero death or neonatal death within the first 28 days of life. Statistical analysis included bivariate and multivariable techniques as well as receiver operator characteristic analysis. Two hundred thirty singleton pregnancies with preterm IUGR meeting the inclusion criteria were identified. Variables associated with perinatal mortality included oligohydramnios and abnormal umbilical artery Dopplers. These two variables had modest predictive value for perinatal mortality. In cases of preterm IUGR, only the presence of abnormal umbilical artery Dopplers or oligohydramnios predicts perinatal mortality.