Improving management of extreme earlyonset fetal growth restriction V1
Research type
Research Study
Full title
Improving the management of extreme early onset fetal growth restriction (eFGR) - a retrospective cohort study
IRAS ID
248646
Contact name
Ed/ED Johnstone
Contact email
Sponsor organisation
University of Manchester
Duration of Study in the UK
2 years, 6 months, 18 days
Research summary
Fetal growth restriction (FGR) is a pregnancy complication in which the developing baby does not reach its expected size. FGR has serious consequences, particularly an increased risk of stillbirth. Most cases of FGR affect babies towards the end of pregnancy, but in a proportion, it occurs much earlier (before 28 weeks of pregnancy). This extreme subset of early-onset FGR, which we term eFGR, has a proportionally greater effect on stillbirth and infant death rates than later-onset FGR, as eFGR-affected infants will die in-utero unless identified and the baby delivered.
One challenge when managing eFGR is timing birth to avoid stillbirth, whilst minimising the risk of infant death. This project aims to address this using data from previous eFGR pregnancies. By collating detailed antenatal and ultrasound data recorded throughout the pregnancy, and collecting data on the pregnancy outcome, it will be possible to identify prognostic indicators of survival and infant morbidity. Statistical modelling techniques will be applied to develop a mathematical model which should allow clinicians to better predict the course of the pregnancy and likely outcome, facilitating improving counselling of affected families, and potentially providing prognostic information for developing future clinical trials. Advancement in our ability to decide the optimal delivery time in eFGR pregnancies is urgently needed, as there is currently a paucity of evidence-based information to guide management in eFGR. If successful, we would anticipate rapid adoption into routine clinical practice, with the aim of reducing the very high associated rates of death and disability.
REC name
West Midlands - Solihull Research Ethics Committee
REC reference
19/WM/0023
Date of REC Opinion
9 Jan 2019
REC opinion
Favourable Opinion