Impact of a Stage-Based Classification on the Incidence of Fetal Growth Restriction, Preterm Birth Rates and Birthweight in a Rural Community of Central India.
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引用次数: 0
Abstract
Introduction: To determine the impact of the stage-based classification of FGR on the magnitude of FGR, preterm births and birthweight in a rural population of Madhya Pradesh in central India Methods: The program covered 168 public sector centres for pregnant women and infants that provided services to nearly 220,000 people. The third-trimester assessments included fetal biometry, growth and environment assessments, and Doppler assessments. Fetal growth was staged using the Barcelona protocol as stages 1 to 4 FGR, small for gestational age (SGA) and no FGR. The data from the last ultrasound assessment before childbirth was considered. Regular training programs covering pre-conception care, antenatal and post-natal care were organized in the local language for the public sector community health workers of the program district. Childbirth outcomes were collected from the obstetric service of the local public sector hospital.
Results: The analysis included 1,229 pregnancies from 2019 to 2023. The overall magnitude of FGR using EFW <10th centile was 19.61% and reduced to 13.34% with the stage-based classification. The magnitude of FGR using the stage-based classification reduced from 27.59% in 2019 to 8.95% in 2023. The PTB in the stage-based FGR subgroup declined from 35.0% in 2019 to 3.45% in 2023 and 96.55% of the stage 1 FGR babies in 2023 were delivered at term. The overall mean birthweight in the program area improved from 2772.41 (357.11) grams in 2019 to 2819.68 (377.31) grams in 2023. The PMR (8.95 per 1,000 pregnancies) in the program area for 2019 to 2023 was much lower than the 31.9 per 1,000 pregnancies reported for Madhya Pradesh.
Conclusion: The change to a stage-based classification of FGR integrated with low-dose aspirin and fetal Doppler studies reduced the incidence of FGR and PTB and perinatal mortality and increased BW in this rural community.
期刊介绍：
The first journal to focus on the fetus as a patient, ''Fetal Diagnosis and Therapy'' provides a wide range of biomedical specialists with a single source of reports encompassing the common discipline of fetal medicine.
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