Analysis of the effectiveness of first trimester screening for fetal growth retardation in the krasnodar territory (cohort study)

Penzhoyan G.A., Mingaleva N.V., Makukhina T.B.

Kuban State Medical University, Krasnodar, Russia

Background: Antenatal detection of fetal growth retardation (FGR) has undeniable advantages, since careful fetal monitoring and optimized timing of delivery can significantly reduce the incidence of adverse perinatal outcomes. The effectiveness of early scree-ning to identify high-risk groups and prevent FGR based on the algorithm proposed by the Fetal Medicine Foundation (FMF) at the population level has been poorly studied. Objective: Evaluation of the effectiveness of the FMF model of first trimester screening for fetal growth retardation in a cohort of women receiving maternity care in the Krasnodar Territory. Materials and methods: An observational retrospective study of data on the results of combined first trimester prenatal screening and birth outcomes in women in labor in the Krasnodar Territory based on the analysis of official reports, information on form 32 of the Federal State Statistics Service for the Krasnodar Territory and the Perinatal Center of the Krasnodar Regional Clinical Hospital No. 2 of the Ministry of Health of the Krasnodar Territory for 8 years (2017–2024) in order to assess the effectiveness of screening and prevention of FGR based on the dynamics of the frequency of births of children with FGR in the screened cohort; the significance of differences was determined when comparing data for certain time periods, differences were considered significant at a level of p<0.05. Results: The study included data on perinatal birth outcomes: n=254,467 in 2017–2020 (before the introduction of the FGR risk calculation), n=218,318 in 2021–2024 (after the introduction). No significant differences in the frequency of stillbirths, neonatal mortality regardless of the gestational age at birth, or in the level of neonatal morbidity among premature infants before and after the implementation of the screening and prevention program for IGR according to the FMF algorithm were found. A significant (p<0.0001) decrease in the frequency of live births with FGR regardless of the gestational age and among premature infants by 32.2% and 29.2%, respectively, was found. Among newborns after the implementation of the algorithm, a decrease in the overall neonatal morbidity by 11.1% (p<0.0001) was found. Conclusion: The implementation of combined screening for FGR based on the FMF algorithm with the identification of a high-risk group for subsequent close monitoring was accompanied by a decrease in the frequency of births of children with FGR. The significance of the impact of the screening program on the level of FGR-associated neonatal diseases requires further study.

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About the Authors

Grigory A. Penzhoyan, Dr. Sci. (Med.), Professor, Head of the Department of Obstetrics, Gynecology and Perinatology No. 2, Institute of Continuous Education, Kuban State Medical University, Krasnodar, Russia; ORCID: https://orcid.org/0000-0002-8600-0532
Natalia V. Mingaleva, Dr. Sci. (Med.), Professor, Professor of the Department of Obstetrics, Gynecology and Perinatology No. 2, Institute of Continuous Education, Kuban State Medical University, Krasnodar, Russia; mingalevaN008@yandex.ru, ORCID: https://orcid.org/0000-0001-5440-3145 (corresponding author)
Tatyana B. Makukhina, Dr. Sci. (Med.), Professor at the Department of Obstetrics, Gynecology and Perinatology No. 2, Institute of Continuous Education, Kuban State Medical University, Krasnodar, Russia; soltatiana@mail.ru, ORCID: https://orcid.org/0000-0003-0536-4500