{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T22:15:12Z","timestamp":1787004912690,"version":"build-2736575974"},"reference-count":19,"publisher":"Georg Thieme Verlag KG","issue":"S 01","funder":[{"DOI":"10.13039\/100006108","name":"National Center for Advancing Translational Sciences","doi-asserted-by":"crossref","award":["UL1TR000101"],"award-info":[{"award-number":["UL1TR000101"]}],"id":[{"id":"10.13039\/100006108","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Am J Perinatol"],"published-print":{"date-parts":[[2024,5]]},"abstract":"<jats:p>Objective\u2003This study aimed to compare adverse maternal outcomes between pregnancies complicated by fetal growth restriction (FGR) and those without FGR.<\/jats:p>\n                  <jats:p>Study Design\u2003This was a secondary analysis of the data from the Consortium on Safe Labor, which was conducted from 2002 to 2008 in 12 clinical centers with 19 hospitals across 9 American College of Obstetricians and Gynecologists districts. We included singleton pregnancies without any maternal comorbidities or placenta abnormalities. We compared the outcomes of individuals with FGR with individuals without FGR. Our primary outcome was severe maternal morbidity. Our secondary outcome included various adverse maternal and neonatal outcomes. Multivariable logistic regression was performed to obtain adjusted odds ratios (aOR) and 95% confidence intervals (95% CI), adjusting for confounders. Missing values for maternal age and body mass index were imputed.<\/jats:p>\n                  <jats:p>Results\u2003Of 199,611 individuals, 4,554 (2.3%) had FGR and 195,057 (97.7%) did not have FGR. Compared with the individuals without FGR, individuals with FGR had increased odds of severe maternal morbidity (0.6 vs. 1.3%; aOR: 1.97 [95% CI: 1.51\u20132.57]), cesarean delivery (27.7 vs. 41.2%; aOR: 2.31 [95% CI: 2.16\u20132.48]), pregnancy-associated hypertension (8.3 vs. 19.2%; aOR: 2.76 [95% CI: 2.55\u20132.99]), preeclampsia without severe features (3.2 vs. 4.7%; aOR: 1.45 [95% CI: 1.26\u20131.68]), preeclampsia with severe features (1.4 vs. 8.6%; aOR: 6.04 [95% CI: 5.39\u20136.76]), superimposed preeclampsia (18.3 vs. 30.2%; aOR: 1.99 [95% CI: 1.53\u20132.59]), neonatal intensive care unit admission (9.7 vs. 28.4%; aOR: 3.53 [95% CI: 3.28\u20133.8]), respiratory distress syndrome (2.2 vs. 7.7%; aOR: 3.57 [95% CI: 3.15\u20134.04]), transient tachypnea of the newborn (3.3 vs. 5.4%; aOR: 1.62 [95% CI: 1.40\u20131.87]), and neonatal sepsis (2.1 vs. 5.5%; aOR: 2.43 [95% CI: 2.10\u20132.80]).<\/jats:p>\n                  <jats:p>Conclusion\u2003FGR was associated with increased odds of severe maternal outcomes in addition to adverse neonatal outcomes.<\/jats:p>\n                  <jats:p>Key Points<\/jats:p>","DOI":"10.1055\/s-0043-1770706","type":"journal-article","created":{"date-parts":[[2023,6,26]],"date-time":"2023-06-26T18:43:33Z","timestamp":1687805013000},"page":"e2195-e2201","source":"Crossref","is-referenced-by-count":5,"special_numbering":"S","title":["The Association between Fetal Growth Restriction and Maternal Morbidity"],"prefix":"10.1055","volume":"41","author":[{"given":"Yara","family":"Hage Diab","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Eastern Virginia Medical School, Norfolk, Virginia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1327-8979","authenticated-orcid":false,"given":"Juliana G.","family":"Martins","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Eastern Virginia Medical School, Norfolk, Virginia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"George","family":"Saade","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Eastern Virginia Medical School, Norfolk, Virginia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tetsuya","family":"Kawakita","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Eastern Virginia Medical School, Norfolk, Virginia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2023,6,26]]},"reference":[{"key":"ref1","doi-asserted-by":"crossref","first-page":"63","DOI":"10.1186\/1471-2393-14-63","article-title":"Fetal growth restriction and the risk of perinatal mortality-case studies from the multicentre PORTO study","volume":"14","author":"J Unterscheider","year":"2014","journal-title":"BMC Pregnancy Childbirth"},{"issue":"01","key":"ref2","doi-asserted-by":"crossref","first-page":"41","DOI":"10.1186\/1824-7288-37-41","article-title":"Intrauterine growth retardation\u2013small events, big consequences","volume":"37","author":"T Saleem","year":"2011","journal-title":"Ital J Pediatr"},{"issue":"02","key":"ref3","doi-asserted-by":"crossref","first-page":"915","DOI":"10.1007\/s00394-021-02695-w","article-title":"Relationship of maternal obesity and vitamin D concentrations with fetal growth in early pregnancy","volume":"61","author":"Q Zhang","year":"2022","journal-title":"Eur J Nutr"},{"issue":"01","key":"ref4","doi-asserted-by":"crossref","first-page":"319","DOI":"10.1196\/annals.1365.047","article-title":"Fetal growth restriction and postnatal development","volume":"1092","author":"M Eleftheriades","year":"2006","journal-title":"Ann N Y Acad Sci"},{"key":"ref5","doi-asserted-by":"crossref","first-page":"S43","DOI":"10.1016\/j.placenta.2008.11.003","article-title":"Placental endoplasmic reticulum stress and oxidative stress in the pathophysiology of unexplained intrauterine growth restriction and early onset preeclampsia","volume":"30","author":"G J Burton","year":"2009","journal-title":"Placenta"},{"issue":"04","key":"ref6","doi-asserted-by":"crossref","first-page":"400","DOI":"10.1002\/uog.13190","article-title":"Perinatal morbidity and mortality in early-onset fetal growth restriction: cohort outcomes of the trial of randomized umbilical and fetal flow in Europe (TRUFFLE)","volume":"42","author":"C Lees","year":"2013","journal-title":"Ultrasound Obstet Gynecol"},{"issue":"04","key":"ref7","doi-asserted-by":"crossref","first-page":"326.e1","DOI":"10.1016\/j.ajog.2010.06.058","article-title":"Contemporary cesarean delivery practice in the United States","volume":"203","author":"J Zhang","year":"2010","journal-title":"Am J Obstet Gynecol"},{"issue":"04","key":"ref8","doi-asserted-by":"crossref","first-page":"B2","DOI":"10.1016\/j.ajog.2020.05.010","article-title":"Society for Maternal-Fetal Medicine consult series #52: diagnosis and management of fetal growth restriction: (replaces clinical guideline number 3, April 2012)","volume":"223","author":"J G Martins","year":"2020","journal-title":"Am J Obstet Gynecol"},{"issue":"05","key":"ref10","doi-asserted-by":"crossref","first-page":"643.e1","DOI":"10.1016\/j.ajog.2015.11.004","article-title":"Measuring severe maternal morbidity: validation of potential measures","volume":"214","author":"E K Main","year":"2016","journal-title":"Am J Obstet Gynecol"},{"issue":"04","key":"ref11","doi-asserted-by":"crossref","first-page":"408","DOI":"10.1111\/ppe.12610","article-title":"Validation of criteria to identify severe maternal morbidity","volume":"34","author":"K P Himes","year":"2020","journal-title":"Paediatr Perinat Epidemiol"},{"key":"ref12","volume-title":"Transient Tachypnea of the Newborn","author":"K Jha","year":"2022"},{"issue":"08","key":"ref15","doi-asserted-by":"crossref","first-page":"785","DOI":"10.1055\/s-0037-1617456","article-title":"Preterm preeclampsia with severe features: composite maternal and neonatal morbidities associated with fetal growth restriction","volume":"35","author":"O A Balogun","year":"2018","journal-title":"Am J Perinatol"},{"issue":"09","key":"ref16","doi-asserted-by":"crossref","first-page":"2422","DOI":"10.1007\/s43032-020-00393-2","article-title":"Fetal growth restriction: does an integrated maternal hemodynamic-placental model fit better?","volume":"28","author":"F Mecacci","year":"2021","journal-title":"Reprod Sci"},{"issue":"02","key":"ref17","doi-asserted-by":"crossref","first-page":"442","DOI":"10.1161\/HYPERTENSIONAHA.118.11092","article-title":"Association between prepregnancy cardiovascular function and subsequent preeclampsia or fetal growth restriction","volume":"72","author":"F L Foo","year":"2018","journal-title":"Hypertension"},{"issue":"05","key":"ref18","doi-asserted-by":"crossref","first-page":"882","DOI":"10.1111\/j.1447-0756.2009.01120.x","article-title":"Clinical features of fetal growth restriction complicated later by preeclampsia","volume":"35","author":"M Mitani","year":"2009","journal-title":"J Obstet Gynaecol Res"},{"issue":"04","key":"ref19","doi-asserted-by":"crossref","first-page":"538.e1","DOI":"10.1016\/j.ajog.2015.06.064","article-title":"Serious maternal complications after early preterm delivery (24-33 weeks' gestation)","volume":"213","author":"U M Reddy","year":"2015","journal-title":"Am J Obstet Gynecol"},{"key":"ref20","doi-asserted-by":"crossref","first-page":"116","DOI":"10.1016\/j.ejogrb.2021.04.022","article-title":"Severe maternal morbidity in preterm cesarean delivery: A systematic review and meta-analysis","volume":"261","author":"J Blanc","year":"2021","journal-title":"Eur J Obstet Gynecol Reprod Biol"},{"issue":"01","key":"ref21","doi-asserted-by":"crossref","first-page":"e1","DOI":"10.1097\/AOG.0000000000003324","article-title":"Female sexual dysfunction: ACOG practice bulletin clinical management guidelines for obstetrician-gynecologists, number 213","volume":"134","author":"American College of Obstetricians and Gynecologists' Committee on Practice Bulletins\u2014Gynecology","year":"2019","journal-title":"Obstet Gynecol"},{"issue":"02","key":"ref22","doi-asserted-by":"crossref","first-page":"e16","DOI":"10.1097\/AOG.0000000000004251","article-title":"ACOG practice bulletin no. 227: fetal growth restriction","volume":"137","author":"American College of Obstetricians and Gynecologists","year":"2021","journal-title":"Obstet Gynecol"}],"container-title":["American Journal of Perinatology"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/www.thieme-connect.de\/products\/ejournals\/pdf\/10.1055\/s-0043-1770706.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,11,5]],"date-time":"2024-11-05T08:35:55Z","timestamp":1730795755000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.thieme-connect.de\/DOI\/DOI?10.1055\/s-0043-1770706"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,6,26]]},"references-count":19,"journal-issue":{"issue":"S 01","published-online":{"date-parts":[[2024,5,13]]},"published-print":{"date-parts":[[2024,5]]}},"URL":"https:\/\/doi.org\/10.1055\/s-0043-1770706","archive":["Portico","CLOCKSS"],"relation":{},"ISSN":["0735-1631","1098-8785"],"issn-type":[{"value":"0735-1631","type":"print"},{"value":"1098-8785","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,6,26]]}}}