Abstract

Growth restriction, where the unborn baby (fetus) is smaller than expected for the weeks of pregnancy, can begin at any time of pregnancy and cause many problems. Factors in both the mother and the baby may cause fetal growth restriction (FGR) which is a major risk factor for perinatal deaths (both stillbirth and neonatal death). Detection of poor fetal growth in pregnancy can be missed and the pregnant woman usually does not have any symptoms. This study examined 6 perinatal deaths that occurred within a large trial which recruited 1,200 ultrasound-dated FGR pregnancies between 24 and 37 weeks’ gestation. The perinatal deaths occurred more commonly in pregnancies with severe growth restriction and associated abnormal ultrasound scan findings. All of the described pregnancies were complicated by either significant risk factors or complications in the mother, and 5 of the 6 deaths occurred in women of non-Irish ethnic backgrounds. Despite this group of pregnancies being under surveillance, not all perinatal deaths were able to be prevented. Future research needs to focus on how the prenatal detection of FGR can be improved, to allow for close monitoring, and on how these pregnancies can be better managed, both to prevent perinatal death.