Neonatal complications and characteristics of postnatal development of infants with fetal growth restriction
Leonova A.A., Kan N.E., Tyutyunnik V.L., Serebriakova A.P., Khachaturyan A.A., Pekareva N.A.
Objective: To investigate neonatal complications and characteristics of postnatal development of infants with fetal growth restriction.
Materials and methods: The retrospective study was carried out in two stages at the Academician V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology, Ministry of Health of Russia (Kulakov Center). The first stage included analysis of the clinical and anamnestic data and the features of the course of pregnancy in 620 women (300 women with fetal growth restriction (FGR) in pregnancy and 320 women with normal pregnancy), and analysis of neonatal complications in 620 newborns (300 newborns who had fetal growth restriction, 320 newborns without fetal growth restriction). All newborns (n=620) underwent neurosonographic examination after birth, followed by analysis of brain structural changes, as well as analysis of somatic, neurological and ophthalmological complications in the neonatal period. The second stage included analysis of postneonatal complications (from day 29 of postnatal development till the age of 1 year) in 207 infants of the total sample (207/620; 33.4%), who underwent follow-up at the Scientific Pediatric Consultative Department of Kulakov Center after discharge. All infants were divided into 2 groups. The main group included infants who had fetal growth restriction (n=115). The comparison group included infants with normal anthropometric parameters (n=92).
Results: The study found that the frequency of complications in newborns with fetal growth restriction was significantly increased. In the neonatal period, these infants were significantly more likely to have central nervous system depression (p<0.001), hypoxic ischemic encephalopathy (p<0.001), retinopathy of prematurity (p<0.001), and pulmonary hypertension (p<0.001). It should be noted that necrotizing enterocolitis (p<0.001), skin hemorrhagic syndrome (p<0.001) and disseminated intravascular coagulation (DIC) (p<0.001) occurred exclusively in the main group. In the postneonatal period, there was delay in physical and psychomotor development in infants with FGR, as well as the frequency of visual impairments increased by 2 times (p<0.001).
Conclusion: Fetal growth restriction is associated with adverse neonatal and postneonatal outcomes. This highlights the need for prevention and early diagnosis of this pregnancy complication, as well as the comprehensive step-by-step rehabilitation for infants with fetal growth restriction in the postnatal period.
Authors' contributions: Leonova A.A., Kan N.E., Tyutyunnik V.L., Serebriakova A.P., Khachaturyan A.A., Pekareva N.A. – development of study concept and design, data obtaining for analysis, review of publications, material collection and analysis on the topic of the study, statistical analysis of the obtained data, manuscript writing and editing.
Conflicts of interest: The authors confirm that they have no conflicts of interest to declare.
Funding: The study was carried out within the framework of the initiative scientific research topic No. 19-I23 of December 08, 2022 “Epigenetic criteria for the diagnosis of fetal growth restriction from the perspective of impaired neurogenesis” (registration No. 123060500032-8 in the Unified State Information System for Accounting the Results of Research, Development and Technological Work for Civil Purposes (EGISU NIOKTR).
Ethical Approval: The study was approved by the local Ethics Committee of the Academician V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology, Ministry of Health of Russia.
Patient Consent for Publication: All patients have signed informed consent for publication of their data.
Authors' Data Sharing Statement: The data supporting the findings of this study are available on request from the corresponding author after approval from the principal investigator.
For citation: Leonova A.A., Kan N.E., Tyutyunnik V.L., Serebriakova A.P., Khachaturyan A.A., Pekareva N.A. Neonatal complications and characteristics of postnatal development of infants with fetal growth restriction.
Akusherstvo i Ginekologiya/Obstetrics and Gynecology. 2025; (7): 67-75 (in Russian)
https://dx.doi.org/10.18565/aig.2025.134
Keywords
fetal growth restriction
neonatal outcomes
catamnesis
psychomotor skill acquisition
cerebral disorders
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Received 19.05.2025
Accepted 28.05.2025
About the Authors
Anastasia A. Leonova, PhD student, Academician V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology, Ministry of Health of Russia, 117997, Russia, Moscow, Ac. Oparina str., 4, +7(937)453-54-27, nastena27-03@mail.ru, https://orcid.org/0000-0001-6707-3464Natalia E. Kan, Professor, Dr. Med. Sci., Honored Scientist of the Russian Federation, Deputy Director for Research – Director of the Institute of Obstetrics, Academician V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology, Ministry of Health of Russia, 117997, Russia, Moscow, Ac. Oparina str., 4,
kan-med@mail.ru, Researcher ID: B-2370-2015, SPIN: 5378-8437, Authors ID: 624900, Scopus Author ID: 57008835600, https://orcid.org/0000-0001-5087-5946
Victor L. Tyutyunnik, Professor, Dr. Med. Sci., Leading Researcher at the Center for Scientific and Clinical Research, Academician V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology, Ministry of Health of Russia, 117997, Russia, Moscow, Ac. Oparina str. 4, tioutiounnik@mail.ru,
Researcher ID: B-2364-2015, SPIN: 1963-1359, Authors ID: 213217, Scopus Author ID: 56190621500, https://orcid.org/0000-0002-5830-5099
Anna P. Serebriakova, obstetrician-gynecologist of the day hospital department for examination of pregnant women, State Healthcare Institution Primorsky Krai Perinatal Center, 690042, Russia, Vladivostok, Mozhayskaya str., 1B, serebriakovanna@gmail.com, https://orcid.org/0000-0001-7014-2627
Anuta A. Khachaturyan, PhD student, Academician V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology, Ministry of Health of Russia, 117997, Russia, Moscow, Ac. Oparina str. 4, x.anyt37@mail.ru, https://orcid.org/0009-0007-3767-9343
Natalia A. Pekareva, Dr. Med. Sci., Head of the Scientific Advisory Pediatric Department, Academician V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology, Ministry of Health of Russia, 117997, Russia, Moscow, Ac. Oparina str. 4, n_pekareva@oparina4.ru, https://orcid.org/0000-0002-2710-864Х
Corresponding author: Anastasia A. Leonova, nastena27-03@mail.ru
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