Hadlock Büyüme Standardına Göre Fetal Büyüme Kısıtlılığı Tanısı Alan Olguların Fenton Büyüme Çizelgesine Göre Oluşturulan Gruplar Arasında Erken Yenidoğan Komplikasyonları Açısından Karşılaştırılması

Abstract

ÖZCAN, S. Comparison of Early Neonatal Complications of fetuses diagnosed as Fetal Growth Restriction according to Hadlock Growth Standard with Neonatal Fenton Growth Chart percentiles, Hacettepe University Faculty of Medicine, Department of Obstetrics and Gynecology, Expertise Thesis, Ankara 2023. Fetal growth restriction continues to be an important cause of perinatal morbidity and mortality. Infants diagnosed with FGR in the early neonatal period; are at risk for hypoglycemia, hypothermia, polysystemia, sepsis, convulsions, necrotizing entericolitis (NEC), intraventricular hemorrhage (IVH), periventricular leukomalacia (PVL), respiratory distress syndrome (RDS), bronchopulmonary dysplasia (BPD), retinopathy of prematurity, phototherapy requirement, increased need for intensive care and mechanical ventilation. In childhood and adulthood, they are at risk for neurodevelopmental problems, obesity, diabetes, hypertension, cardiovascular diseases. In this retrospective clinical study, we aimed to examine whether there was a difference in terms of early neonatal complications between the groups formed according to the Fenton growth chart used in the neonatal period of the babies we followed with the diagnosis of fetal growth restriction in our clinic between 2016 and 2021. We accepted EFW < 10 percentile for the diagnosis of FGR. In the neonatal period, we grouped the babies as SGA and AGA according to the birth weight percentiles. A total of 290 patients born between 24 weeks and 36 weeks and 6 days were included in the study population. Of the patients diagnosed with FGR, 135 (46.6%) were evaluated as SGA and 155 as AGA according to the Fenton growth chart. A statistically significant difference was found in the need for transfusion (p=0.005) and body weight gain (g/day) (p=0.036) between the SGA and AGA groups according to Fenton's growth chart in terms of complications. In the group evaluated as AGA, transfusion requirement decreased and weight gain in the neonatal period was found to be normal at a higher rate. There was no statistically significant difference in terms of other neonatal complications. In the groups formed according to birth weeks (<34 weeks and 34 weeks), there was a statistically significant difference between AGA and SGA babies in the group born at <34 weeks in terms of transfusion need (p=0.019), and in the group born at 34 weeks in terms of RDS (p=0.039) and transition time to full enteral nutrition (p=0.009). In conclusion, according to our study, fetal growth standards maintain their prognostic importance in terms of predicting early neonatal complications. However, prospective studies with a larger number of patients are needed to eliminate the discordance between fetal growth standards and neonatal growth charts.