The effect of maternal fatigue on the risk of fetal growth retardation.

OBJECTIVES

The purpose of this study is to investigate the influence of fatigue trajectories on fetal growth during pregnancy.

METHODS

Pregnant women and their fetuses were recruited at 11-13 weeks of gestation. Fatigue was assessed using the Chalder Fatigue Scale. Fetal growth was monitored through three ultrasound examinations. Growth Mixture Models characterized fatigue trajectories during pregnancy, while Generalized Estimating Equations analyzed the relationship between fatigue and fetal growth. Latent Growth Curve Models further explored how changes in fatigue and fetal growth affected their trajectories.

RESULTS

The analysis included 782 pregnant women. The GEEs revealed significant differences in fetal growth metrics-BPD, AC, and FL, across four groups based on fatigue trajectory (P total < 0.001). Compared to the non-fatigued group, the persistent fatigue group showed significantly lower BPD (β = 0.067, 95 % CI 0.021-0.220 P < 0.001), AC (β < 0.001, 95 % CI 1.432E-08-0.001; P < 0.001), and FL (β = 0.073, 95 % CI 0.027-0.196; P < 0.001), next was the early fatigue group. Parallel process LGCM results showed that higher initial levels of maternal fatigue during pregnancy were associated with lower baseline BPD (r = -0.062, P = 0.022), AC (r = -0.147, P = 0.030), and FL (r = -0.458, P = 0.004) measurements. In addition, we observed that the change in the slope of maternal fatigue also affected the change in the AC measurements (β = -0.917, P = 0.015).

CONCLUSION

Maternal fatigue during pregnancy impacts fetal growth. Initial levels of fatigue predicted the trajectory of fetal growth changes, and the slope of change in fatigue simultaneously affected the slope of change of infant growth, highlighting the importance of comprehensive management and intervention for excessive fatigue.