{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,25]],"date-time":"2025-11-25T07:33:09Z","timestamp":1764055989211,"version":"3.45.0"},"reference-count":30,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2025,5,24]],"date-time":"2025-05-24T00:00:00Z","timestamp":1748044800000},"content-version":"vor","delay-in-days":23,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Pregnancy"],"published-print":{"date-parts":[[2025,5]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background and Objective<\/jats:title>\n                    <jats:p>Extreme early\u2010onset fetal growth restriction (EE\u2010FGR) is associated with significant perinatal morbidity and mortality. As short\u2010 and long\u2010term prognoses are influenced by both gestational age and severity of FGR, quantifying risk is inherently challenging. We hypothesized that a meta\u2010analysis would provide quantifiable estimates of perinatal outcomes in pregnancies complicated by EE\u2010FGR.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We searched PubMed, Scopus, Embase, and Web of Science databases for relevant studies published from inception to March 2024. We included all original studies involving singleton pregnancies with estimated fetal weights (EFWs) or abdominal circumferences &lt; third centile or EFWs &lt; 600 g, between 20\u00a0+\u00a00 and 26\u00a0+\u00a06 weeks of gestation. Studies were limited to fetuses with no known chromosomal, genetic, or major structural abnormalities. The National Institute of Health Quality Assessment Tool was utilized for the risk of bias assessment. Incidence meta\u2010analyses were performed with proportions (percentages) calculated for each outcome using a random\u2010effects model.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Five cohort studies (three prospective and two retrospective), comprising a total of 614 pregnancies, were included in the review. Two studies had overlapping populations; in such cases, the study containing the most relevant variables was selected for analysis. Four studies demonstrated good quality, and one was of fair quality. Pregnancy loss occurred at a rate of 39% (95% confidence interval [CI]: 29%\u201349%). Among live births, neonatal death was observed in 14% (95% CI: 4%\u201324%). Preterm birth (&lt;37 weeks) was reported in 68% of cases (95% CI: 40%\u201396%), with very preterm birth (&lt;32 weeks) accounting for 61% (95% CI: 34%\u201388%) of these, and extreme preterm birth (&lt;28 weeks) comprising 25%. Additionally, 29% (95% CI: 20%\u201339%) of pregnancies were complicated by preeclampsia and\/or hemolysis, elevated liver enzyme levels, and low platelet levels (HELLP) syndrome, with high heterogeneity (\n                      <jats:italic>I<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      &gt; 50%) across outcomes.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Our meta\u2010analyses quantitated the incidence of adverse fetal, neonatal, and maternal outcomes with EE\u2010FGR, with the risk of pregnancy loss or neonatal death approaching nearly 50%, and among survivors, more than two thirds were born preterm. These findings provide valuable data for counseling families facing EE\u2010FGR, though high heterogeneity highlights the need for further research.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial Registration<\/jats:title>\n                    <jats:p>PROSPERO database [CRD42019120930].<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/pmf2.70034","type":"journal-article","created":{"date-parts":[[2025,5,24]],"date-time":"2025-05-24T12:55:04Z","timestamp":1748091304000},"source":"Crossref","is-referenced-by-count":0,"title":["Quantifying prenatal and postnatal mortality in extreme early onset fetal growth restriction: A systematic review and incidence analysis"],"prefix":"10.1002","volume":"1","author":[{"given":"Shohra","family":"Qaderi","sequence":"first","affiliation":[{"name":"Fetal Care and Surgery canter, Division of Fetal Medicine and Surgery Boston Children's Hospital, Harvard Medical School  Boston Massachusetts USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Giulia","family":"Bonanni","sequence":"additional","affiliation":[{"name":"Fetal Care and Surgery canter, Division of Fetal Medicine and Surgery Boston Children's Hospital, Harvard Medical School  Boston Massachusetts USA"},{"name":"Department of Women, Children, and Public Health Sciences IRCCS Agostino Gemelli University Polyclinic Foundation, Catholic University of the Sacred Heart  Rome Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mohammadamin","family":"Parsaei","sequence":"additional","affiliation":[{"name":"Breastfeeding Research Center, Family Health Research Institute Tehran University of Medical Sciences  Tehran Iran"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ehsan","family":"Rojhani","sequence":"additional","affiliation":[{"name":"Fetal Care and Surgery canter, Division of Fetal Medicine and Surgery Boston Children's Hospital, Harvard Medical School  Boston Massachusetts USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Satjeet Deol","family":"Chauhan","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology BronxCare Health System\/Icahn School of Medicine at Mount Sinai  Bronx New York USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eyal","family":"Krispin","sequence":"additional","affiliation":[{"name":"Fetal Care and Surgery canter, Division of Fetal Medicine and Surgery Boston Children's Hospital, Harvard Medical School  Boston Massachusetts USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dario O.","family":"Fauza","sequence":"additional","affiliation":[{"name":"Department of Surgery Boston Children's Hospital\/Harvard Medical School  Boston Massachusetts USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anna L.","family":"David","sequence":"additional","affiliation":[{"name":"UCL Elizabeth Garrett Anderson Institute for Women's Health University College London  London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kjersti","family":"Aagaard","sequence":"additional","affiliation":[{"name":"Fetal Care and Surgery canter, Division of Fetal Medicine and Surgery Boston Children's Hospital, Harvard Medical School  Boston Massachusetts USA"},{"name":"HCA Healthcare and HCA Research Institute  Nashville Tennessee USA"},{"name":"National Director of Perinatal Research and HCA Healthcare Gulf Coast Division &amp; HCA Texas Maternal Fetal Medicine  Houston Texas USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alireza A.","family":"Shamshirsaz","sequence":"additional","affiliation":[{"name":"Fetal Care and Surgery canter, Division of Fetal Medicine and Surgery Boston Children's Hospital, Harvard Medical School  Boston Massachusetts USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2025,5,24]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(10)62233-7"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.15884"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1067\/mob.2001.116686"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.3109\/14767058.2011.587061"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.15973"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.AOG.0000253215.79121.75"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1203\/00006450-200107000-00017"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.semperi.2004.08.006"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-3476(05)80965-5"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(14)62049-3"},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.1159\/000058108"},{"key":"e_1_2_11_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(96)04547-3"},{"key":"e_1_2_11_14_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1651-2227.2004.tb00236.x"},{"key":"e_1_2_11_15_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12884-017-1226-7"},{"key":"e_1_2_11_16_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.n71"},{"key":"e_1_2_11_17_1","doi-asserted-by":"publisher","DOI":"10.1007\/978-3-031-36033-6_14"},{"key":"e_1_2_11_18_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13643-016-0384-4"},{"key":"e_1_2_11_19_1","doi-asserted-by":"publisher","DOI":"10.1172\/JCI169199"},{"key":"e_1_2_11_20_1","unstructured":"National Institute of Health.2014. \u201cQuality Assessment Tool for Observational Cohort and Cross\u2010Sectional Studies.\u201dhttps:\/\/www.nhlbi.nih.gov\/health\u2010topics\/study\u2010quality\u2010assessment\u2010tools."},{"key":"e_1_2_11_21_1","doi-asserted-by":"publisher","DOI":"10.1201\/9781003107347"},{"key":"e_1_2_11_22_1","doi-asserted-by":"publisher","DOI":"10.1136\/archdischild-2022-325285"},{"key":"e_1_2_11_23_1","doi-asserted-by":"publisher","DOI":"10.2307\/2533446"},{"key":"e_1_2_11_24_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.315.7109.629"},{"key":"e_1_2_11_25_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.0006-341X.2000.00455.x"},{"key":"e_1_2_11_26_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.3953"},{"key":"e_1_2_11_27_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jogoh.2022.102514"},{"key":"e_1_2_11_28_1","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0000000000002548"},{"key":"e_1_2_11_29_1","doi-asserted-by":"publisher","DOI":"10.1111\/aogs.13702"},{"key":"e_1_2_11_30_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2023.06.035"},{"key":"e_1_2_11_31_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2017.11.048"}],"container-title":["Pregnancy"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/pmf2.70034","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,11,25]],"date-time":"2025-11-25T07:29:03Z","timestamp":1764055743000},"score":1,"resource":{"primary":{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/10.1002\/pmf2.70034"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,5]]},"references-count":30,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2025,5]]}},"alternative-id":["10.1002\/pmf2.70034"],"URL":"https:\/\/doi.org\/10.1002\/pmf2.70034","archive":["Portico"],"relation":{},"ISSN":["2997-9684","2997-9684"],"issn-type":[{"type":"print","value":"2997-9684"},{"type":"electronic","value":"2997-9684"}],"subject":[],"published":{"date-parts":[[2025,5]]},"article-number":"e70034"}}