From the Guidelines
The risk of having fetal growth restriction (FGR) in a subsequent pregnancy after experiencing it once is approximately 20-25%. This means that if you've had one pregnancy affected by FGR, you have about a 1 in 4 or 1 in 5 chance of it happening again in your next pregnancy 1. However, this risk can vary based on several factors including the underlying cause of the previous FGR, your health conditions, and whether those conditions are still present or have been addressed. Some key factors to consider include:
- The presence of maternal hypertensive disease, which is common in early-onset FGR and plays an important role in pregnancy outcomes 1
- The use of prophylactic low-dose aspirin, which has been shown to provide a modest risk reduction in FGR and SGA in some meta-analyses, but its effectiveness is still a topic of debate 1
- The importance of early and regular prenatal care, with more frequent ultrasounds typically recommended to monitor fetal growth 1
It's essential to note that there are currently no preventative strategies or treatments for FGR that have been proven to be effective, and the use of low-molecular-weight heparin or sildenafil is not recommended for the sole indication of FGR prevention 1. Maintaining a healthy lifestyle with proper nutrition, avoiding smoking and alcohol, and managing any chronic health conditions can also help reduce the risk of recurrence. Regular monitoring and timely delivery are crucial in reducing perinatal mortality and minimizing short- and long-term morbidity 1.
From the Research
Recurrence Risk of Fetal Growth Restriction
- The risk of recurrence of fetal growth restriction (FGR) after one pregnancy is estimated to be around 20% to 30% 2, 3.
- This risk highlights the importance of close surveillance and management in subsequent pregnancies.
Factors Influencing Recurrence
- The severity of FGR in the previous pregnancy can influence the risk of recurrence, with more severe cases potentially leading to a higher risk 2.
- Effective preventive strategies are currently lacking, although low-dose aspirin may be somewhat effective in preventing FGR 2, 3, 4.
Management of Subsequent Pregnancies
- Surveillance in subsequent pregnancies may consist of serial ultrasonography, with the timing and frequency determined by the clinical severity in the index pregnancy 2.
- Optimization of maternal medical conditions, smoking cessation, and accurate dating by first-trimester sonography are also important in managing subsequent pregnancies 3.
- In women with nutritional deficiencies, optimizing caloric intake may help prevent recurrent FGR 3.