Overview
The goal of this clinical trial is to learn if maternal left-lateral positioning in pregnancy works to treat fetal growth restriction. This study will also help us learn about the effects of left-lateral positioning on maternal metabolomics, maternal mental health, fetal cardiac function, and delivery outcomes. The main questions it aims to answer are:
- Does maternal left-lateral position in a pregnancy with fetal growth restriction improve the baby's growth?
- How are maternal metabolomics, delivery outcomes, maternal mental health, and fetal cardiac function impacted by maternal left-lateral position? Researchers will compare the intervention group to pregnancies with fetal growth restriction that receive standard of care (without left-lateral positioning) to see if left-lateral position improves fetal biometry in fetal growth restriction.
Participants will:
- Practice left-lateral position every day for 4 hours (cumulatively) with 10-mins stretching after every hour of left-lateral position, or continue to receive standard of care
- Visit the clinic once after 4 weeks for a follow-up research visit, and at the time of delivery
Tracking of the physical activity and adherence to left-lateral position at home in intervention group A will be done through a fitbit (smart watch) given during enrollment. A fitbit will also be given to participants in intervention group B, receiving standard of care, to monitor their physical activity trends at home.
Eligibility
Inclusion Criteria:
- Pregnant persons between 18 - 65 years of age, with a diagnosis of fetal growth restriction, with an estimated fetal weight less than tenth percentile
- Participants with a singleton pregnancy between 24- and 34-weeks' gestational age
- Participants with fluency in English or Spanish language
Exclusion Criteria:
- Patients with a known history of deep vein thrombosis, pulmonary embolism, or hypercoagulability disorder
- Patients with a pre-pregnancy BMI greater than 40
- Pregnancy with severe abnormality in umbilical artery Doppler flow, including absent end-diastolic flow (AEDF) and reverse end-diastolic flow (REDF)
- Patients receiving anticoagulation therapy
- Pregnancy with suspected chromosomal anomalies or a multifetal pregnancy
- Patients with an active smoking status during pregnancy