Silva Marilia de Lacerda, Oliveira Barbara Coppola, Dos Santos Felipe Augusto Pereira, Rodrigues Karine Mendonça Davi, de Sousa Luis Ronan Marquez Ferreira, Caetano Ana Carolina Rabachini, Araujo Júnior Edward, Nardozza Luciano Marcondes Machado, Peixoto Alberto Borges
Hospital Universitário Mario Palmério - Universidade de Uberaba (UNIUBE), Uberaba, MG, Brazil.
Universidade Federal do Triângulo Mineiro (UFTM), Uberaba, MG, Brazil.
Radiol Bras. 2025 Sep 1;58:e20250031. doi: 10.1590/0100-3984.2025.0031. eCollection 2025 Jan-Dec.
To evaluate the association between first-trimester screening for fetal growth restriction (FGR) and the effect of aspirin use as prophylaxis for this condition, as well as its effect on adverse maternal and perinatal outcomes. A secondary objective was to evaluate the association between a high risk of FGR and adverse perinatal outcomes.
This was a retrospective cohort study of pregnant women who did or did not undergo first-trimester screening for FGR. Screening for FGR involved the evaluation of maternal characteristics, mean arterial pressure, and the results of uterine artery Doppler. Pregnancies with an estimated risk ≥ 1:155 were categorized as high risk, whereas those with an estimated risk < 1:155 were categorized as low risk.
We evaluated 499 pregnant women who did not undergo first-trimester screening for FGR (unscreened group) and 615 who did (screened group). The risk of gestational hypertension was lower in the screened group, as evidenced by an adjusted odds ratio (aOR) of 0.24 (95% CI: 0.14-0.39; < 0.001), as was the risk of spontaneous preterm birth at < 37 weeks of gestation (aOR: 0.22; 95% CI: 0.10-0.45; < 0.001). The risk of delivery at < 32 weeks was higher in the screened group (aOR: 8.25; 95% CI: 1.05-65.71; < 0.045) as was the risk of delivery at < 37 weeks (aOR: 5.91; 95% CI: 2.62-13.31; < 0.001). Among all of the pregnancies at high risk of FGR (in both groups), there was an increased risk of delivery at < 32 weeks (3.1% vs. 0.2%; OR: 16.20; 95% CI: 2.20-190.90; = 0.004), and at < 37 weeks (10.7% vs. 1.4%; OR: 8.41; 95% CI: 3.60-22.10; < 0.0001). The use of aspirin was associated with a greater prevalence of gestational hypertension (8.0% vs. 2.1%; OR: 4.1; 95% CI: 1.77-10.10; = 0.0014) and of a birth weight < 2,500 g (14.5% vs. 7.3%; OR: 2.14; 95% CI: 1.25-3.71; = 0.009).
First-trimester screening for FGR seems to be associated with a higher risk of preterm birth (at < 32 and < 37 weeks). Pregnancies that are at high risk of FGR appear to also be at a higher risk of adverse perinatal outcomes. Aspirin use seems to be associated with a greater prevalence of developing gestational hypertension and of a birth weight < 2,500 g.
评估孕早期胎儿生长受限（FGR）筛查与使用阿司匹林预防该疾病的效果之间的关联，以及其对孕产妇和围产期不良结局的影响。次要目的是评估FGR高风险与围产期不良结局之间的关联。
这是一项对接受或未接受孕早期FGR筛查的孕妇进行的回顾性队列研究。FGR筛查包括评估孕产妇特征、平均动脉压和子宫动脉多普勒检查结果。估计风险≥1:155的妊娠被归类为高风险，而估计风险<1:155的妊娠被归类为低风险。
我们评估了499名未接受孕早期FGR筛查的孕妇（未筛查组）和615名接受了筛查的孕妇（筛查组）。筛查组妊娠高血压的风险较低，校正比值比（aOR）为0.24（95%CI：0.14 - 0.39；P<0.001），妊娠<37周时自发性早产的风险也较低（aOR：0.22；95%CI：0.10 - 0.45；P<0.001）。筛查组妊娠<32周时分娩的风险较高（aOR：8.25；95%CI：1.05 - 65.71；P<0.045），妊娠<37周时分娩的风险也较高（aOR：5.91；95%CI：2.62 - 13.31；P<0.001）。在所有FGR高风险的妊娠中（两组均有），妊娠<32周时分娩的风险增加（3.1%对0.2%；OR：16.20；95%CI：2.20 - 190.90；P = 0.004），妊娠<37周时分娩的风险也增加（10.7%对1.4%；OR：8.41；95%CI：3.60 - 22.10；P<0.0001）。使用阿司匹林与妊娠高血压的患病率较高相关（8.0%对2.1%；OR：4.1；95%CI：1.77 - 10.10；P = 0.0014），以及出生体重<2500g的患病率较高相关（14.5%对7.3%；OR：2.14；95%CI：1.25 - 3.71；P = 0.009）。
孕早期FGR筛查似乎与早产风险较高（<32周和<37周）相关。FGR高风险的妊娠似乎也有更高的围产期不良结局风险。使用阿司匹林似乎与妊娠高血压的患病率较高以及出生体重<2500g的患病率较高相关。
