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Recording available 2/16-5/2
Recording available 2/16-5/2
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Abstract Award
Abstract Award
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Poster Session 1

Category: Ultrasound/Imaging

Poster Session 1

(247) Decreased growth velocity is associated with adverse outcomes in normally grown and growth restricted fetuses

Wednesday, February 11, 2026
10:30 AM - 12:00 PM  

    Submitting Author and Presenting Author(s)

  • JL

    Joseph Levy, MD, PhD

    Maternal Fetal Medicine Fellow, PGY-6
    University of Missouri-Kansas City
    University of Missouri-Kansas City, Missouri, United States

    • Coauthor(s)

  • AD

    Avery Day, MD

    University of Missouri-Kansas City
    Kansas City, Missouri, United States

  • MS

    Mason Sifford, MD

    University of Missouri-Kansas City
    Kansas City, Missouri, United States

  • CR

    Chloe Ramirez Biermann, MD

    University of Missouri-Kansas City
    Kansas City, Missouri, United States

  • ZA

    Zachary Alholm, MD

    University of Missouri-Kansas City
    Kansas City, Missouri, United States

  • AO

    Anthony O. Odibo, MD, MSCE

    University of Missouri Kansas City
    Kansas City, Missouri, United States

Objective:
The current Society for Maternal Fetal Medicine (SMFM) diagnosis for fetal growth restriction is based on the estimated fetal weight (EFW) or the abdominal circumference, whereas the International Society of Ultrasound in Obstetrics and Gynecology (ISUOG) recommends evaluation of growth velocity as a possible risk factor for growth restriction. We sought to estimate the association between falling fetal growth velocity and adverse pregnancy outcomes (APO).

Study Design:
A retrospective cohort study of all singleton gestations with at least two growth ultrasounds during their pregnancy with known pregnancy outcomes between 2019 and 2025. Growth velocity was calculated as the difference between the last and first ultrasound EFW Z-Score, based on the Hadlock growth curve. The APO was defined as a composite outcome including at least one of the following: 5-minute APGAR score ≤7, umbilical cord arterial pH < 7.1, cesarean delivery for non-reassuring fetal heart rate, stillbirth, and infant hospital length of stay (Above 90%ile = >4.5 days). Analysis includes descriptive and multivariant logistic regression.

Results:
Among the 6,469 included deliveries, the mean gestational age (GA) at the first and last ultrasound were 21.8 and 33.9 weeks, respectively. The APO was observed in 1,190 patients (18.4%). The association between the change in EFW Z-Score and the APO is shown in the table. A fall in the Z-score greater than 2.0 had the highest associated with APO (aOR 1.84 95% CI 1.21-2.78){adjusted for GA at delivery}. The final EFW, when less than 10%ile, was also associated with the APO (aOR 1.56, 95% CI 1.26-1.93), but was less predictive than a Z-Score change greater than 2. A Z-score greater than 2.0 was associated with all the individual components of the composite APO except for 5-minute APGAR scores (see table).

Conclusion:
Although both EFW and Z-Score are associated with APO, the fall in fetal growth velocity appears to be a better predictor of APO.