Conflict of interest The authors have stated explicitly that there are no conflicts of interest in connection with this article.
Main Research Article
Effects of antenatal recognition and follow-up on perinatal outcomes in small-for-gestational age infants delivered after 36 weeks
Article first published online: 5 DEC 2012
© 2012 The Authors Acta Obstetricia et Gynecologica Scandinavica© 2012 Nordic Federation of Societies of Obstetrics and Gynecology
Acta Obstetricia et Gynecologica Scandinavica
Volume 92, Issue 2, pages 223–229, February 2013
How to Cite
FRATELLI, N., VALCAMONICO, A., PREFUMO, F., PAGANI, G., GUARNERI, T. and FRUSCA, T. (2013), Effects of antenatal recognition and follow-up on perinatal outcomes in small-for-gestational age infants delivered after 36 weeks. Acta Obstetricia et Gynecologica Scandinavica, 92: 223–229. doi: 10.1111/aogs.12020
Please cite this article as: Fratelli N, Valcamonico A, Prefumo F, Pagani G, Guarneri T, Frusca T. Effects of antenatal recognition and follow-up on perinatal outcomes in small-for-gestational age infants delivered after 36 weeks. Acta Obstet Gynecol Scand. 2012; 91: DOI: 10.1111/aogs.12020.
- Issue published online: 23 JAN 2013
- Article first published online: 5 DEC 2012
- Accepted manuscript online: 27 SEP 2012 10:27AM EST
- Received: 24 December 2011 Accepted: 19 September 2012
- middle cerebral artery;
- small-for-gestational age;
- umbilical artery
Objective. To compare perinatal outcomes of late small-for-gestational age (SGA, birthweight <10th percentile) infants, according to antenatal recognition. Design. Retrospective study. Setting. Tertiary referral center. Population. All singleton pregnancies with SGA (birthweight <10th percentile) infants born ≥36 weeks’ gestation from January 2007 to April 2009. Methods: Chart review of 771 pregnancies. SGA infants identified prior to delivery (group A) were compared with those not identified (group B). Main outcome measures. Mode of delivery, perinatal complications, admission to neonatal intensive care unit (NICU). In group A, receiver operating characteristic (ROC) analysis and area under the curve (AUC) of antenatal tests to predict NICU admission were calculated. Results. In 17% of infants, SGA was recognized before birth (group A), whereas in 83% it was recognized only at birth (group B). Infants with the most severe degree of SGA (birthweight <3rd percentile) were more frequently diagnosed antenatally (30%). Admission to NICU (14 vs. 3%, p < 0.001) and cesarean delivery (42 vs. 26%; p < 0.001) were more likely in group A. Adverse outcomes related to hypoxia were all observed in group B, but the difference was not significant. In antenatally detected fetuses a combination of fetal abdominal circumference, umbilical artery pulsatility index and middle cerebral artery pulsatility index z-scores was useful for prediction of NICU admission (AUC = 0.94). Conclusion. Antenatal recognition of late SGA may improve perinatal outcomes. However, admission to neonatal intensive care and cesarean delivery were more frequent among SGA infants recognized antenatally.