Improving the management of early-onset fetal growth restriction

Our researchers want to find better ways of helping women whose babies show signs early in pregnancy that they are not growing properly.
  • Author's list

    Dr Lynne Warrander, Dr Emma Ingram, Professor Alexander Heazell, Professor Ed Johnstone

    Start date: April 2017
    End date: January 2021

  • Research centre

  • Research status

    Ongoing projects

Why do we need this research?

Fetal growth restriction (eFGR) is a pregnancy complication in which the developing baby does not reach its expected size. Most cases are caused by failure of the placenta, and this has serious consequences for the baby, particularly an increased risk of stillbirth

Most cases of fetal growth restriction affect babies towards the end of pregnancy, but in a small proportion of pregnancies, it occurs much earlier, before 28 weeks. This is known as early-onset fetal growth restriction, or eFGR. Babies with eFGR have a much higher risk of stillbirth or death soon after birth

One of the challenges when managing eFGR is the timing of the birth. Babies need to stay in the womb as long as possible in order to reduce the risk of complications after birth, but prolonging the pregnancy increases the risk of stillbirth. There is a lack of good research on how to best manage pregnancies affected by this problem. 

What’s happening in this project?

Tommy’s researchers want to find out more about eFGR so that they can work out how to improve the care given to affected babies. They found that eFGR affects around 3 in every 1000 premature births, and that babies have a better chance of survival if they are heavier at birth and if they have stayed in the womb for longer. The team have identified key things to look for on ultrasound scans that can help to predict a baby’s chance of survival following diagnosis of eFGR. They have also seen how heartbeats differ between babies with eFGR and babies who are growing as they should, and want to find out more about how these differences can be used to predict the likely outcome of a pregnancy.

What difference will this project make?

We now have more information about the chances of survival for a baby with eFGR, so can give parents a better idea of how their pregnancy is likely to progress. Next, our researchers want to carry out a clinical trial to test whether they can use the predictive factors they have identified to estimate the chance of survival more accurately for each baby with eFGR, which would help doctors better decide when it is safest to deliver the baby.