Relationship Between Co-occurring Fetal Growth Restriction and Preeclampsia
Location
Center for Advanced Learning & Simulation (CALS)
Publication Date
May 2026
Start Date
8-5-2026 11:15 AM
End Date
8-5-2026 11:30 AM
Description
Objective: Preeclampsia (Pre-E) and fetal growth restriction (FGR) frequently coexist and may share underlying pathophysiology, though whether FGR should be included in Pre-E diagnostic criteria remains debated. While their combined presence is associated with worsened maternal cardiovascular markers and disease severity, the impact of the timing of each diagnosis on outcomes is unclear. This study aimed to evaluate whether the order of FGR and Pre-E diagnosis is associated with differences in maternal and fetal outcomes.
Methods: This retrospective cohort study included patients with both preeclampsia (Pre-E) and fetal growth restriction (FGR) at a single academic center (2017–2022), excluding multifetal gestations, fetal anomalies, and uncertain dating. Patients were grouped by diagnosis order (FGR-first vs Pre-E-first). Maternal outcomes included magnesium use, and unplanned cesarean delivery; fetal outcomes included gestational age at delivery, birthweight, and birth percentile. Comparisons were performed using Mann–Whitney U and Fisher’s exact tests, with p<0.05 considered significant.
Results: A total of 27 patients met inclusion criteria, with 14 in the FGR-first group and 13 in the Pre-E-first group. Gestational age at initial diagnosis was earlier in the Pre-E-first group compared to the FGR-first group (25.2±6.3 vs 29.4±4.8 weeks, p=0.08). Patients diagnosed with Pre-E prior to FGR had a significantly longer interval from diagnosis to delivery compared to those with FGR first (10.0±7.2 vs 5.9±3.2 weeks, p=0.02). Gestational age at delivery was similar between groups (35±3 vs 35±4 weeks, p=0.92). Magnesium sulfate use was more frequent in the FGR-first group (53.8% vs 85.7%, p=0.09). No meaningful differences were observed in birthweight (2050±600 vs 1960±700 g, p=0.68), or delivery mode.
Conclusions: FGR diagnosed prior to preeclampsia was associated with a shorter interval from diagnosis to delivery, and increased magnesium use suggesting a more rapidly progressive disease course compared to cases in which preeclampsia occurs first. Larger prospective studies are needed to confirm these findings and to better characterize how the timing of these diagnoses should inform monitoring and delivery planning.
Recommended Citation
Karunasiri, Chaya MD/MPH; Denneny, Rachel MD; Duplessis, Heather MD; John, Sidney MD; and Dubuisson, Emily MD, "Relationship Between Co-occurring Fetal Growth Restriction and Preeclampsia" (2026). Dept. of Obstetrics & Gynecology Resident Research Day. 9.
https://digitalscholar.lsuhsc.edu/obgyn_rd/2026/presentations/9
Relationship Between Co-occurring Fetal Growth Restriction and Preeclampsia
Center for Advanced Learning & Simulation (CALS)
Objective: Preeclampsia (Pre-E) and fetal growth restriction (FGR) frequently coexist and may share underlying pathophysiology, though whether FGR should be included in Pre-E diagnostic criteria remains debated. While their combined presence is associated with worsened maternal cardiovascular markers and disease severity, the impact of the timing of each diagnosis on outcomes is unclear. This study aimed to evaluate whether the order of FGR and Pre-E diagnosis is associated with differences in maternal and fetal outcomes.
Methods: This retrospective cohort study included patients with both preeclampsia (Pre-E) and fetal growth restriction (FGR) at a single academic center (2017–2022), excluding multifetal gestations, fetal anomalies, and uncertain dating. Patients were grouped by diagnosis order (FGR-first vs Pre-E-first). Maternal outcomes included magnesium use, and unplanned cesarean delivery; fetal outcomes included gestational age at delivery, birthweight, and birth percentile. Comparisons were performed using Mann–Whitney U and Fisher’s exact tests, with p<0.05 considered significant.
Results: A total of 27 patients met inclusion criteria, with 14 in the FGR-first group and 13 in the Pre-E-first group. Gestational age at initial diagnosis was earlier in the Pre-E-first group compared to the FGR-first group (25.2±6.3 vs 29.4±4.8 weeks, p=0.08). Patients diagnosed with Pre-E prior to FGR had a significantly longer interval from diagnosis to delivery compared to those with FGR first (10.0±7.2 vs 5.9±3.2 weeks, p=0.02). Gestational age at delivery was similar between groups (35±3 vs 35±4 weeks, p=0.92). Magnesium sulfate use was more frequent in the FGR-first group (53.8% vs 85.7%, p=0.09). No meaningful differences were observed in birthweight (2050±600 vs 1960±700 g, p=0.68), or delivery mode.
Conclusions: FGR diagnosed prior to preeclampsia was associated with a shorter interval from diagnosis to delivery, and increased magnesium use suggesting a more rapidly progressive disease course compared to cases in which preeclampsia occurs first. Larger prospective studies are needed to confirm these findings and to better characterize how the timing of these diagnoses should inform monitoring and delivery planning.
Comments
Advisor: Asha Heard MD/MPH