The association between small size for gestational age and perinatal and neonatal death in a UK Regional Health Authority.
Confidential enquiry into stillbirth and death in infancy is a health service requirement in England, Wales and Northern Ireland. A confidential review of perinatal death has been conducted in South-East Thames Region since 1988. Data collected for this review are analysed here. Among the 1662 singleton deaths in the enquiry from 1988 to 1991, 530 (32%) babies were small for gestational age (SGA < 10th centile): 338 of these (64%) were < 3rd centile and the remainder were between 3rd-10th centile. Small size for gestational age was significantly associated with a previous SGA baby (P = 0.02), proteinuric hypertension (P = 0.001) and increased placental-birthweight ratio (P = 0.008). Only 135 (25%) SGA fetuses were identified antenatally and multiple logistic regression showed that antenatal detection was independently related to proteinuric hypertension [odds ratio (OR) = 2.47, 95% confidence interval (CI) 1.47-4.17, P = 0.001) and to being < 3rd centile rather than 3rd-10th centile (OR = 3.16, 95% CI 1.96-5.10, P = 0.001). Although confidential enquiries have been criticised for a lack of objectivity the study indicates how data from such an enquiry can increase knowledge of events influencing peri- and neonatal outcome allowing strategies to be devised to effect change.
de Courcy-Wheeler
R H
RH
Regional Perinatal Monitoring Group South East Thames Regional Health Authority, UK.
Wolfe
C D
CD
Warburton
F
F
Goodman
J
J
Reynolds
F
F
Gamsu
H
H
D003625:Data Collection / Q000379:methods*; D004739:England / Q000453:epidemiology; D005260:Female; D005317:Fetal Growth Retardation / Q000175:diagnosis / Q000453:epidemiology / Q000517:prevention & control*; D005865:Gestational Age; D006801:Humans; D007226:Infant Mortality; D007231:Infant, Newborn; D007236:Infant, Small for Gestational Age / Q000254:growth & development; D016015:Logistic Models; D011225:Pre-Eclampsia / Q000453:epidemiology; D011247:Pregnancy; D011296:Prenatal Diagnosis / Q000706:statistics & numerical data*; D011446:Prospective Studies; D012307:Risk Factors