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Scientists have developed a new way to predict pregnancy outcomes for the mothers of unborn babies with early-onset foetal growth restriction (FGR).
FGR affects approximately 60,000 babies in Europe and the USA every year. It is an obstetric condition where the baby is much smaller than expected due to slow growth in the womb.
While some babies with FGR will continue to grow and be born around their due date, some either need extreme preterm delivery (before 28 weeks of pregnancy) or will not survive the pregnancy, resulting in stillbirth.
Predicting pregnancy outcomes helps expectant mothers to have a better idea of what to expect and helps doctors decide how often to do ultrasound scans and when to give antenatal steroids to prepare the baby for preterm delivery.
Ultrasounds and blood samples taken from pregnant women
In total, 142 women who had severe early-onset FGR were included in the study, all of whom had ultrasounds which revealed their babies were still very small even in the second half of pregnancy (between 20 and 27 weeks).
These women were followed up throughout their pregnancy and had regular ultrasound examinations of their baby’s size and wellbeing.
Blood samples were taken from 123 women, and the researchers measure the levels of 102 proteins in the samples from 63 of these women.
These readings were combined with the ultrasound measurements to build statistical models that could predict pregnancy outcomes.
The team asked both women and their doctors about which pregnancy outcomes they thought were important to them, these included:
- Foetal or neonatal death
- Death or delivery before 28 weeks
- Development of abnormal umbilical artery Dopplers
- Delivery at 37 weeks or more.
Researchers then used measurements from the other 60 women, of the study cohort, to validate the models predicting these outcomes.
There are currently no therapies which improve foetal growth inside the womb
They found that by assessing the ultrasound and protein measurements – both alone and combined – they were able to predict which pregnancies would end in stillbirth or neonatal death, and which may require extreme preterm delivery before 28 weeks of pregnancy.
Senior author, Professor Anna David, said this new technique will enable experts to choose which women would benefit the most from taking part in a clinical trial which is testing a drug which could improve foetal growth.
“Currently we have no therapy to improve foetal growth inside the womb but a novel drug is being developed by our team. This will need to be tested in clinical trials,” she said. “These results will help researchers to identify those women who might be most suitable to participate in the clinical trial, where the possible benefits outweigh the risks.”
“Better prediction of which pregnancies will end in stillbirth, neonatal death or extreme preterm delivery will help to identify who should be included in these trials,” she added.