Re-evaluating the Use of Contraction Stress Test in Term Fetal Growth Restriction: A Retrospective Study

Abstract

Purpose This study aimed to evaluate the prognostic utility of the contraction stress test (CST) for fetuses diagnosed with Fetal Growth Restriction (FGR) and its impact on perinatal outcomes. Methods A retrospective cohort study analyzed data from term singleton deliveries over two years. FGR was diagnosed with a birthweight below the 3rd percentile or prenatally below the 10th percentile with abnormal Doppler findings. The comparison included SGA fetuses, defined by birthweight between the 3rd and 10th percentiles. The cohort was categorized into three groups: 1) FGR with negative CST, 2) FGR without CST, and 3) SGA fetuses. Primary outcomes were emergency cesarean delivery rates, and secondary outcomes included composite neonatal adverse events and a combined metric of neonatal and maternal adverse events. Results The analysis included 1,688 records: 33 FGR with negative CST, 275 FGR without CST, and 1,123 SGA. Emergency cesarean delivery rates were similar between FGR with negative CST (15.2%) and without CST (14.9%), but higher compared to SGA (9.7%, p = .025). Composite neonatal adverse events did not differ significantly between FGR groups (21.2% vs 24.7%) but were higher than SGA (8.1%, p < .001). Combined neonatal and maternal adverse events also did not differ between FGR groups (30.3% vs 33.5%) but were higher than SGA (15.1%, p < .001). Conclusion The contraction stress test did not reduce the risk of adverse maternal or neonatal outcomes in fetuses diagnosed with fetal growth restriction.