Small-for-gestational-age babies of low-risk term pregnancies: does antenatal detection matter?

J Matern Fetal Neonatal Med. 2018 Jun;31(11):1426-1430. doi: 10.1080/14767058.2017.1317741. Epub 2017 Apr 24.

Abstract

Objectives: To compare delivery route and admission rate to neonatal intensive care unit between small- and appropriate-for-gestational-age babies among low-risk term pregnancies.

Methods: A retrospective study was conducted using the database of deliveries in 2014 at a tertiary hospital. Babies delivered at ≥37 weeks with birthweight <10th centile were considered small-for-gestational-age (SGA) and >90th centile were considered large-for-gestational-age. Fetal weight estimation at 30-33 weeks ultrasound <10th centile was considered antenatal detection of SGA.

Results: Among 1429 low-risk term pregnancies, 11% (151/1429) had SGA babies and 5% (75/1429) had large-for-gestational-age. SGA babies were associated with higher rate of cesarean sections for nonreassuring fetal status (18/151 versus 8/1202, p < .001) and higher rate of admissions to neonatal intensive care unit (16/151 versus 18/1202, p < .001) compared to appropriate-for-gestational-age. Within SGA group, antepartum detected fetuses were associated with lower rate of operative deliveries for nonreassuring fetal status than undetected group (3/31 versus 39/120, p = .01) Conclusions: In our series, women with SGA term babies were associated with more adverse obstetric and neonatal outcome than appropriate-for-gestational age, especially among those undetected prenatally.

Keywords: Small-for-gestational-age; antenatal screening; cesarean delivery; neonatal intensive care unit admission; nonreassuring fetal status.

MeSH terms

  • Adult
  • Delivery, Obstetric / statistics & numerical data*
  • Female
  • Humans
  • Infant, Newborn
  • Infant, Small for Gestational Age*
  • Portugal / epidemiology
  • Pregnancy
  • Pregnancy Outcome / epidemiology*
  • Retrospective Studies
  • Ultrasonography, Prenatal
  • Young Adult