An externally validated normogram for predicting short-term pregnancy outcome of singleton pregnancies with fetal growth restriction (FGR)

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Abstract Background: The object of this study was to develope an available predictive model of singleton pregnancies with fetal growth restriction (FGR) for accurate and individualized prognosis assessment. Methods: The prediction nomogram was developed by multivariable Cox regression with data for 301 singleton FGR pregnancies at Peking University People’s Hospital. External validation was performed in 321 eligible singleton FGR pregnancies at the Affiliated Hospital of Qingdao University. Results: Absent umbilical arterial flow, fetal anomaly, history of adverse pregnancy, non-head fetal position and history of caesarean section were independent prognostic factors for adverse perinatal outcomes (APOs) in singleton FGR pregnancies in the training set. The nomogram estimated pregnancy prognosis of FGR singleton pregnancies based on these five variables, with a C-index of 0.859 in the training cohort. In the external validation set, consistent results were observed with a C-index of 0.776 for the nomogram. Moreover, the calibrations of the nomograms predicting 28th and 34th TOP-free gestation week (GW) strongly corresponded to the actual survival outcome. Conclusion: The prediction model in this study may help clinicians in decision-making for singleton pregnancies with FGR, especially for the patient with single abnormal umbilical arterial flow or fetal anomaly, without induced labor indications for these abnormalities.

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