The "weight" of fetal growth restriction in 437 hypertensive pregnancies.

OBJECTIVE

Our objective was to evaluate the outcomes of the hypertensive and preeclamptic pregnancies with or without fetal growth restriction (FGR).

METHODS

We retrospectively studied 437 hypertensive pregnant women treated by calcium antagonists and divided in four groups: Gestational hypertension (GH) with or without FGR (GH-AGA: 244; GH-FGR: 78) and preeclampsia (PE) with or without FGR (PE-AGA: 76; PE-FGR: 39). Outcomes considered were: the need for a second-line treatment, prolongation of the pregnancy after diagnosis, duration of treatment in puerperium, gestational age at delivery, neonatal birth weight, perinatal mortality and neonatal malformations.

RESULTS

A second line treatment was added in: GH-AGA: 15.4% vs. GH-FGR: 32.8%; PE-AGA: 28% vs. PE-FGR: 50%. We found a significant difference in delivery delay after diagnosis (31.3+/-5.4 vs. 20.7+/-3.4 days and 35.3+/-4.5 vs. 22.2+/-3.1; p<0.001). Gestational age at delivery was (p<0.001): 35.5+/-2.3 vs. 35.6+/-2.5 and 34.4+/-1.7 vs. 33.1+/-2.3. A significant difference in birth weight was (p<0.001): 2,271+/-759.1 vs. 1,817.59+/-396.9 and 2,196+/-685.17 vs. 1,465.80+/-441.7. Mortality was 2.56% (2 cases) for GH-FGR and 10.2% (4 cases) for PE-FGR. No neonates showed malformations.

CONCLUSIONS

Gestational hypertension and preeclampsia increase the risk of low birth weight, on the other hand the fetal growth restriction is a determinant factor for the outcome of hypertensive and preeclamptic pregnancy, perinatal morbidity and mortality of the fetus and for the management and treatment efficacy of the mother.