Gardosi Jason, Francis Andre
West Midlands Perinatal Institute, Birmingham, England, UK.
Am J Obstet Gynecol. 2009 Jul;201(1):28.e1-8. doi: 10.1016/j.ajog.2009.04.034.
The objective of the study was to investigate the association between pregnancy complications and small for gestational age (SGA) birthweight, comparing SGA based on the customized growth potential with SGA based on the birthweight standard of the same population.
This was a retrospective analysis of a database from a US multicenter study. Pregnancy complications included threatened preterm labor, antepartum hemorrhage, pregnancy-induced hypertension, preeclampsia, stillbirth, and early neonatal death.
Compared with SGA by the birthweight standard, SGA by customized growth potential showed higher risk for each of the 6 adverse indicators. A third of the SGA group was small by customized centiles but not by population-based centiles, yet was strongly associated with each of the pregnancy complications studied. This subgroup of unrecognized SGA babies included 26% preterm deliveries. In contrast, a subgroup that was SGA by the population standard but not by the customized standard (17.2%), was not associated with any of the indicators of adverse outcome.
SGA defined by customized growth potential improves the differentiation between physiologically and pathologically small babies.
本研究的目的是调查妊娠并发症与小于胎龄儿（SGA）出生体重之间的关联，比较基于定制生长潜能的SGA与基于同一人群出生体重标准的SGA。
这是一项对美国多中心研究数据库的回顾性分析。妊娠并发症包括先兆早产、产前出血、妊娠高血压、子痫前期、死产和早期新生儿死亡。
与基于出生体重标准的SGA相比，基于定制生长潜能的SGA在6项不良指标中的每一项上都显示出更高的风险。SGA组中有三分之一按照定制百分位数是小样儿，但按照基于人群的百分位数不是，然而它与所研究的每种妊娠并发症都密切相关。这个未被识别的SGA婴儿亚组包括26%的早产。相比之下，按照人群标准是SGA但按照定制标准不是的亚组（17.2%），与任何不良结局指标均无关联。
由定制生长潜能定义的SGA改善了生理性和病理性小样儿之间的区分。
