Outcome of small for gestational age preterm singletons: a population-based cohort study

Natasa Tul; Mateja Lasic; Katja Bricelj; Andreja Trojner Bregar; Ivan Verdenik; Miha Lucovnik; Isaac Blickstein

doi:10.1515/jpm-2015-0321

Article

Outcome of small for gestational age preterm singletons: a population-based cohort study

Natasa Tul , Mateja Lasic , Katja Bricelj , Andreja Trojner Bregar , Ivan Verdenik , Miha Lucovnik and Isaac Blickstein

Published/Copyright: May 13, 2016

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From the journal Journal of Perinatal Medicine Volume 44 Issue 8

Abstract

Objective:

To examine the outcomes of births among small and appropriate for gestational age (SGA and AGA) infants by gestational age and maternal characteristics.

Materials and methods:

We used a national perinatal registry to compare the selected maternal and neonatal outcomes between AGA and SGA neonates born at gestational age groups 33–36, 30–32, 28–29, and <28 weeks. We evaluated maternal body mass index (BMI), pre-gestational/gestational diabetes, hypertensive disorders, and cesarean births as well as frequencies of 5-min Apgar score <7, intraventricular hemorrhage (IVH), respiratory distress syndrome (RDS), the need for assisted ventilation, and early neonatal deaths.

Results:

We evaluated 159,774 AGA (8871 preterm) and 13,735 SGA (1147 preterm) infants and found a gradual decrease in the incidence of SGA infants with increasing gestational age. Diabetes was unrelated to having an SGA or AGA infant among preterm births, but the odds ratio (OR) for preeclampsia among preterm-SGA pregnancies was up to 6.9 (95% CI 3.8, 12.5) at <28 weeks. SGA infants fare worse compared to AGA neonates in every parameter tested but only in preterm births >30 weeks.

Conclusions:

Being SGA further complicates preterm births after 30 weeks of gestation but not earlier. This might suggest that an extended period in the hostile intrauterine environment, or that being born at <30 weeks, is bad enough and is not further aggravated by being SGA.

Keywords: Neonatal outcome; preterm birth; pregnancy complications; small for gestational age

Corresponding author: Isaac Blickstein, MD, Department of Obstetrics and Gynecology, Kaplan Medical Center, 76100 Rehovot, Israel, Tel.: +972-545201789

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The authors stated that there are no conflicts of interest regarding the publication of this article.

Received: 2015-9-15

Accepted: 2016-4-18

Published Online: 2016-5-13

Published in Print: 2016-11-1

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Articles in the same Issue

https://doi.org/10.1515/jpm-2015-0321

Keywords for this article

Neonatal outcome; preterm birth; pregnancy complications; small for gestational age