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Am J Perinatol. 2014 Mar;31(3):187-94. doi: 10.1055/s-0033-1343771. Epub 2013 Apr 16.

Prenatal detection of fetal growth restriction in newborns classified as small for gestational age: correlates and risk of neonatal morbidity.

Author information

1
Department of Obstetrics and Gynecology, Eastern Virginia Medical School, Norfolk, Virginia.
2
Graduate Program in Public Health, Eastern Virginia Medical School, Norfolk, Virginia.
3
Department of Obstetrics and Gynecology, Medical University of South Carolina, Charleston, South Carolina.
4
Department of Obstetrics and Gynecology, University of Arkansas, Little Rock, Arkansas.
5
Department of Obstetrics and Gynecology, Brown University, Providence, Rhode Island.
6
Department of Obstetrics and Gynecology, Temple University, Philadelphia, Pennsylvania.
7
Department of Obstetrics and Gynecology, Naval Medical Center Portsmouth, Portsmouth, Virginia.
8
Department of Obstetrics and Gynecology, College of Physicians and Surgeons, Columbia University, New York.

Abstract

We examined the rate of detecting small for gestational age (SGA; birth weight < 10%) as intrauterine growth restriction (IUGR) prenatally at four centers and determined risks of composite neonatal morbidity (CNM) and mortality among detected versus undetected (no antenatal diagnosis of IUGR). A multicenter cohort study of 11,487 nonanomalous, singleton live births with sonographic exam before 22 weeks was performed. Of 11,487 births, 8% (n = 929) were SGA that met the inclusion criteria, with 25% of them being prenatally detected. The CNM among SGA births that were prenatally detected as IUGR was higher (23.3%) than undetected SGA (9.7%), but this difference was no longer significant following adjustments for confounding factors. Among preterm births (< 37 weeks), undetected SGA had significantly higher CNM (risk ratio [RR] 10.0, 95% confidence interval [CI] 6.3, 16.1) for deliveries at 24 to 33 weeks and RR 3.0, 95% CI 1.7, 5.4 for 34 to 36 weeks). In summary, only a quarter of SGA births were detected prenatally as IUGR and among preterm SGA, the CNM is significantly higher when SGA births are undetected as IUGR.

PMID:
23592315
DOI:
10.1055/s-0033-1343771
[Indexed for MEDLINE]

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