Aviram Amir, Yogev Yariv, Bardin Ron, Meizner Israel, Wiznitzer Arnon, Hadar Eran
a Rabin Medical Center, Helen Schneider Hospital for Women , Petah Tikva , Israel and.
J Matern Fetal Neonatal Med. 2015 Sep;28(13):1520-4. doi: 10.3109/14767058.2014.961912. Epub 2014 Sep 26.
We aimed to evaluate whether pre-recognition of small for gestational age (SGA) at late preterm or term pregnancies, has an impact on pregnancy outcome.
Retrospective analysis of SGA newborns, stratified to those with suspected or unsuspected IUGR according the sonographic estimated fetal weight (EFW), below the 10th percentile for gestational age (n = 619), with fetuses not suspected as SGA (EFW ≥10th percentile) preformed up to 7 days prior to delivery (n = 1770).
SGA was correctly diagnosed prior to delivery in 26% of the fetuses. Women with suspected SGA were delivered earlier (37.9 ± 1.7 versus 38.8 ± 1.4 weeks, p < 0.001) and at a lower birth weight (2280 ± 321 versus 2454 ± 263 grams, p < 0.001). They also had higher rates of induction of labor (19.1% versus 6.2%, p < 0.001) and cesarean delivery (29.1% versus 19.8%, p < 0.001). Fetuses suspected for SGA had higher rate of neonatal adverse outcome, but on multivariate analysis suspected SGA (aOR 0.41, 95% CI 0.20-0.86), birthweight (aOR 0.67, 95% CI 0.5 to -0.77 for each additional 50 g), gestational age at delivery (aOR 0.63, 95% CI 0.56-0.71 for each additional week) and spontaneous vaginal delivery (aOR 0.88, 95% CI 0.19-3.89) were independently associated with an improved neonatal composite outcome.
Identification of SGA may improve neonatal outcome. However, by itself, it is not an indication for intervention, which may lead to adverse outcome.
我们旨在评估在晚期早产或足月妊娠时对小于胎龄儿（SGA）的预先识别是否会对妊娠结局产生影响。
对SGA新生儿进行回顾性分析，根据超声估计胎儿体重（EFW）将其分为疑似或未疑似宫内生长受限（IUGR）的新生儿，胎龄低于第10百分位数（n = 619），以及在分娩前7天内未被怀疑为SGA的胎儿（EFW≥第10百分位数）（n = 1770）。
26%的胎儿在分娩前被正确诊断为SGA。疑似SGA的孕妇分娩时间更早（37.9±1.7周对38.8±1.4周，p<0.001），出生体重更低（2280±321克对2454±263克，p<0.001）。她们的引产率（19.1%对6.2%，p<0.001）和剖宫产率（29.1%对19.8%，p<0.001）也更高。疑似SGA的胎儿新生儿不良结局发生率更高，但多因素分析显示，疑似SGA（调整后比值比[aOR]0.41，95%置信区间[CI]0.20 - 0.86）、出生体重（每增加50克，aOR 0.67，95% CI 0.5至 - 0.77）、分娩时的胎龄（每增加一周，aOR 0.63，95% CI 0.56 - 0.71）和自然阴道分娩（aOR 0.88，95% CI 0.19 - 3.89）与改善的新生儿综合结局独立相关。
识别SGA可能改善新生儿结局。然而，其本身并非干预的指征，干预可能导致不良结局。
