Factors Associated with Fetal Growth Restriction and Small-For-Gestational-Age Fetuses in a Private Tertiary Care Hospital

Objective: To describe risk factors associated with fetal growth restriction (FGR) and small-for-gestational-age (SGA) fetuses and assess their presence in a private tertiary-care hospital population. Methods: A retrospective observational cohort study included singleton pregnancies diagnosed with impaired fetal growth between April 2018 and September 2022 at a Maternal–Fetal Medicine unit. Cases were classified as early- or late-onset FGR or SGA according to standardized diagnostic criteria. Maternal characteristics, comorbidities, obstetric history, biochemical markers, and neonatal outcomes were analyzed using nonparametric statistics. Results: Among 143 eligible patients, 15 (10.5%) had early-onset FGR, 47 (32.9%) late-onset FGR, and 81 (56.6%) SGA. Demographic characteristics were similar across groups. Most patients had normal pregestational BMI; however, inadequate gestational weight gain was frequent. Early-onset FGR was associated with significantly lower birthweight (p = 0.000). Preeclampsia correlated with lower neonatal weight, while assisted reproductive technology (ART) pregnancies showed higher mean birthweight. Conclusions: In this cohort, inadequate gestational weight gain emerged as a frequent potentially modifiable factor. Strengthening nutritional counseling and multidisciplinary prenatal care may improve perinatal outcomes.