International Journal of Clinical Obstetrics and Gynaecology

Background:Preeclampsia (PE), which significantly impacts maternal and neonatal morbidity and mortality, is a multisystem illness of pregnancy characterized by the start of hypertension and signs of maternal organ dysfunction occurring after 20 weeks of gestation. Fetal growth restriction (FGR) is a primary cause of stillbirth and neonatal mortality. The aim of our study is to assess whether including FGR as a diagnostic criterion for preeclampsia is associated with greater maternal disease severity.
Methods: A retrospective analytical study was conducted among 101 singleton pregnancies diagnosed with preeclampsia before 37 weeks’ gestation. Cases were classified as Group A (PE with FGR, N=24) and Group B (PE without FGR, N=77). Baseline demographics, maternal outcomes (severe hypertension, HELLP, ICU admission), and perinatal outcomes (birthweight, gestational age, NICU admission) were collected.
Results: Group A patients presented and delivered earlier (32.4±4.8 vs 36.6±3.3 weeks, p<0.01) and had significantly lower neonatal birthweights (1520±610 g vs 2590±655 g, p<0.01). Maternal morbidity did not differ between groups: severe hypertension (70.8 vs 61.0%, P=0.38), intravenous antihypertensives (41.7 vs 45.5%, P=0.76), and composite complications (20.8 vs 22.1%, P=0.89). NICU admission (66.7 vs 27.3%, p<0.01) and perinatal death (12.5 vs 3.9%, p<0.05) were significantly higher in Group A.
Conclusions: FGR as a diagnostic criterion signifies a placentally mediated, early-onset preeclampsia linked to adverse neonatal outcomes while exhibiting comparable maternal morbidity.