How good are we at first-trimester prevention and prediction of early fetal growth restriction?

A series of recent publications have shown that early preeclampsia can be successfully predicted in the first trimester using a combination of maternal, biophysical and biochemical factors [1] [2] [3] [4], and administration of low-dose aspirin to women identified as high-risk can reduce the development of preterm preeclampsia by about 60 % [5]. Given that abnormal placentation and placental insufficiency are commons pathway to many cases of preeclampsia and fetal growth restriction (FGR), we intuitively use the same strategies to predict and prevent FGR. However, are we as successful in FGR as we are in preeclampsia?

• References

• 1 Tan MY, Poon LC, Rolnik DL. et al. Prediction and prevention of small-for-gestational-age neonates: evidence from SPREE and ASPRE. Ultrasound Obstet Gynecol 2018
• 2 Tan MY, Wright D, Syngelaki A. et al. Comparison of diagnostic accuracy of early screening for pre-eclampsia by NICE guidelines and a method combining maternal factors and biomarkers: results of SPREE. Ultrasound Obstet Gynecol 2018
• 3 O’Gorman N, Wright D, Poon LC. et al. Multicenter screening for preeclampsia by maternal factors and biomarkers at 11–13 weeks’ gestation: comparison to NICE guidelines and ACOG recommendations. Ultrasound Obstet Gynecol 2017
• 4 O’Gorman N, Wright D, Poon LC. et al. Accuracy of competing risks model in screening for pre-eclampsia by maternal factors and biomarkers at 11–13 weeks’ gestation. Ultrasound Obstet Gynecol 2017
• 5 Rolnik DL, Wright D, Poon LC. et al. Aspirin versus Placebo in Pregnancies at High Risk for Preterm Preeclampsia. N Engl J Med 2017
• 6 Gordijn SJ, Beune IM, Thilaganathan B. et al. Consensus definition of fetal growth restriction: a Delphi procedure. Ultrasound Obstet Gynecol 2016; 48: 333-339
• 7 Poon LC, Syngelaki A, Akolekar R. et al. Combined screening for preeclampsia and small for gestational age at 11–13 weeks. Fetal Diagn Ther 2013; 33: 16-27