FREQUENCY AND ASSOCIATION OF THE FACTORS INFLUENCINGFETAL GROWTH RESTRICTION IN THE REPUBLIC OF KAZAKHSTAN

Abstract

Introduction: A fetus with fetal growth restriction (FGR), characterized by not reaching its intrauterine growth potential
as a result of multiple risk factors, is prone to high morbidity and mortality compared to healthy infants.
The aim of the present study was to evaluate the influence of risk factors hypothesized to negatively affect FGR.
Materials and Methods: The design of this study was a retrospective study, occurring between 1 January 2016 and 31
December 2021. The Inclusion criteria: the presence of ultrasound screening of the first trimester of pregnancy at 10-14
weeks, single pregnancy, pregnancy between 22 and 42 weeks gestation. The exclusion criteria included multiple
pregnancies, pregnancies complicated by neonatal chromosomal or structural anomalies of the fetus.
Statistical analysis. All variables were examined to determine whether they were normally distributed. Descriptive
statistics included median (Q1 – Q3) for the continuous non-normally distributed variables. Results were compared between
newborns with FGR and without FGR. The Mann-Whitney test was used between two groups to compare the means of nonnormally variables. The χ2 test was performed for comparing differences in categorical variables between groups. All
confidence intervals (CI) were 95%. Statistical significance was defined as p<0.05 for a single test.
Results: In this study, 3211 girls and 3336 boys were born, out of which 85 girls and 75 boys had FGR. 6355 newborns
were born alive and 192 newborns were stillborn, of which 136 newborns with FGR were born alive and 24 newborns with
FGR were stillborn (p = 0.001). Pregnancies with pre-eclampsia had significantly higher odds of developing FGR than
pregnancies without pre-eclampsia (p < 0.001). Placental abruption of normally located placenta; Disorder of maternalplacental blood flow according to Doppler results; fetal distress and oligohydramnios were more common in newborns with
FGR than newborns without FGR (p < 0.001). Umbilical cord anomaly in this pregnancy, newborns with FGR occurred more
frequently compared to newborns without umbilical cord anomaly (p = 0.029). Low-lying placenta and complete placenta
previa according to the ultrasound scan were more common in newborns with FGR compared to newborns without FGR (p =
0.006) and (p = 0.001), respectively. 
Conclusions: In our study, FGR was more common in pregnant women with AH, cardiac rhythm disturbance, pulmonary
and bronchial diseases and syphilis than in pregnant women without these diseases. FGR was associated with preeclampsia, presence of uterine scar, HELLP, placental abruption of a normally located placenta, disorder of maternalplacental blood flow according to Doppler results, oligohydramnios, fetal distress, umbilical cord anomalies, Low-lying
placenta and complete placenta previa according to the ultrasound scan.