ArticleBMC pregnancy and childbirth2026
Comparison of adverse perinatal outcomes in late-onset fetal growth restriction with Delphi procedure consensus criteria.
Article in BMC pregnancy and childbirth, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundThe problem of the management of fetal growth restriction (FGR) is in lack of gold standard. Several experts established a consensus definition of FGR through Delphi procedure, while few studies focus on the perinatal outcomes among sub-types of late-onset FGR diagnosed by Delphi procedure consensus criteria.
objectiveTo compare the adverse perinatal outcomes in different subgroups of late-onset FGR according to the Delphi procedure consensus criteria.
methodsA retrospective study was conducted between 2013 and 2020 including late-onset FGR diagnosed by Delphi consensus: Group 1, estimated fetal weight (EFW) or abdominal circumference (AC)<3rd centile; Group 2, EFW or AC<10th centile and umbilical artery pulsatility index (UA-PI) > 95th centile; Group 3, EFW or AC<10th centile and EFW or AC crossing centiles > 2 quartiles on growth centiles; Group 4, EFW or AC crossing centiles > 2 quartiles on growth centiles and UA-PI > 95th centile. Adverse perinatal outcomes (APOs) of 1071 late-onset FGR, including cesarean or instrumental delivery for non-reassuring fetal status, acidosis, neonatal hyperbilirubinemia, respiratory problems, and any adverse perinatal outcome, were compared with appropriate gestational age (AGA) group (Group 5, n = 515) as adjusted odds ratio (aOR) and 95% confidence intervals (CI).
results1071 subjects with late-onset FGR were included, 371(34.6%), 67(6.3%), 516(48.2%), and 117(10.9%) were classified into four groups respectively according to Delphi standard. All mortalities occurred in fetuses with an EFW < 3rd percentile. Compared with Group 5, Group 1 showed the highest risk concerning any APOs (aOR = 4.91, 95% CI: 3.53–6.84), acidosis (aOR = 5.81, 95% CI: 2.96–11.37), neonatal hyperbilirubinemia (aOR = 4.71, 95% CI: 3.30–6.71) and respiratory problems (aOR = 3.65, 95% CI: 2.31–5.77) in the multivariable-adjusted model. As the risk of APOs in Group 2 (aOR = 2.60, 95% CI: 1.44–4.73) and Group 3 (aOR = 1.55, 95% CI = 1.11–2.16) followed, we did not find an increasing APOs risk in Group 4 (aOR = 0.88, 95% CI: 0.49–1.58).
conclusionsAccording to the Delphi consensus, the morbidity was inconsistent among different types of late-onset FGR. EFW or AC < 3rd percentile presented the highest risk of APOs. Compared with AGAs, Group 4 was not associated with an increasing risk of APOs. Further study is needed to develop protocols for the risk-stratification management of late-onset FGR.
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