Long-term neurological outcomes of offspring misdiagnosed with fetal growth restriction

Amir Snir, Omri Zamstein, Tamar Wainstock, Eyal Sheiner

Research output: Contribution to journalArticlepeer-review


Objective: Fetal growth restriction (FGR) is a major determinant of adverse short- and long-term perinatal outcomes. The current definition of FGR (estimated fetal weight measurement < 10th percentile) may lead, at times, to a false diagnosis of fetuses that are eventually born appropriate for gestational age (AGA). Our objective was to investigate the potential association between a misdiagnosis of antepartum fetal growth restriction and long-term neurological outcomes in offspring. Study design: A population-based cohort analysis was performed including deliveries between the years 1991–2020 in a tertiary medical center. We compared neurological hospitalization during childhood among AGA infants falsely diagnosed as FGR versus AGA infants without a false FGR diagnosis. A Kaplan–Meier survival curve was used to assess cumulative morbidity and a Cox proportional hazards model was employed to control for confounders. Results: During the study period, 324,620 AGA infants met the inclusion criteria; 3249 of them were falsely classified as FGR. These offspring had higher rates of hospitalizations due to various neurological conditions, as compared to those without an FGR diagnosis (OR 1.431, 95% CI 1.278–1.608; P < 0.001). In addition, cumulative hospitalization incidence was elevated in the FGR group (log-rank P-value < 0.001). When controlling for confounders, a false FGR diagnosis remained independently associated with long-term neurological morbidities (adjusted HR 1.086, 95% CI 1.003–1.177, P = 0.043). Conclusion: Misdiagnosis of FGR in the antepartum period is associated with an increased risk for offspring long-term neurological morbidities.

Original languageEnglish
JournalArchives of Gynecology and Obstetrics
StateAccepted/In press - 1 Jan 2024


  • Early term labor
  • False FGR diagnosis
  • Long-term neurological outcomes
  • Preterm labor

ASJC Scopus subject areas

  • Obstetrics and Gynecology


Dive into the research topics of 'Long-term neurological outcomes of offspring misdiagnosed with fetal growth restriction'. Together they form a unique fingerprint.

Cite this