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Does antenatal identification of small‐for‐gestational age fetuses significantly improve their outcome?
Author(s) -
Lindqvist P. G.,
Molin J.
Publication year - 2005
Publication title -
ultrasound in obstetrics and gynecology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.202
H-Index - 141
eISSN - 1469-0705
pISSN - 0960-7692
DOI - 10.1002/uog.1806
Subject(s) - medicine , small for gestational age , fetus , obstetrics , apgar score , odds ratio , pregnancy , gestational age , pediatrics , genetics , biology
Objectives Most obstetric clinics have a program for the identification of small‐for‐gestational age (SGA) fetuses because of the increased risk of fetal complications that they present. We have a structured model for the identification and follow‐up of SGA pregnancies. We aimed to determine whether the recognition of SGA antepartum improves fetal outcome. Methods All pregnancies at Malmö University Hospital from 1990 to 1998 ( n = 26 968) were reviewed. SGA fetuses identified prior to delivery ( n = 681) were compared with those not identified ( n = 573). Also, all pregnancies with SGA fetuses were compared with those appropriate‐for‐gestational age (AGA) ( n = 24 585). The risk of serious fetal complications (hypoxic encephalopathy grade 2 or 3, intracranial hemorrhage, Apgar score <4 at 5 min, neonatal convulsions, umbilical pH <7.0, cerebral palsy, mental retardation, stillbirth, intrapartum or infant death) was assessed with cross‐tabulation and logistic regression analysis, adjusted for gestational age and degree of SGA. Results When compared with SGA fetuses identified before delivery (54%), SGA fetuses not identified before delivery were characterized by a four‐fold increased risk of adverse fetal outcome (odds ratio, 4.1; 95% CI, 2.5–6.8). Similarly, compared with AGA fetuses, SGA fetuses were associated with a four‐fold increased risk of serious fetal complications. Conclusions A structured antenatal surveillance program for fetuses identified as SGA results in a lower risk of adverse fetal outcome, compared with cases of SGA fetuses not identified antepartum. Copyright © 2005 ISUOG. Published by John Wiley & Sons, Ltd.