title: Differences in late fetal death rates in association with determinants of small for gestational age fetuses: population based cohort study.
abstract: OBJECTIVE
  To examine differences in late fetal death rates in association with determinants of small for gestational age fetuses.
  
  
  METHODS
  Population based cohort study.
  
  
  METHODS
  1 026 249 pregnancies without congenital malformations.
  
  
  METHODS
  Sweden 1983-92.
  
  
  METHODS
  Late fetal death rate.
  
  
  RESULTS
  Depending on underlying determinants late fetal death rates were greatly increased in extremely small for gestational age fetuses (range 16 to 45 per 1000) compared with non-small for gestational age fetuses (1.4 to 4.6). In extremely small for gestational age fetuses late fetal death rates were increased from 31 per 1000 in mothers aged less than 35 years to 45 per 1000 in older mothers, and from 22 per 1000 in women <155 cm in height to 33 per 1000 in women >=175 cm tall. Late fetal death rates were also higher in extremely small for gestational age fetuses in singleton compared with twin pregnancies and in non-hypertensive pregnancies compared with pregnancies complicated by severe pre-eclampsia or other hypertensive disorders. Slightly higher late fetal death rates were observed in nulliparous compared with parous women and in non-smokers compared with smokers.
  
  
  CONCLUSIONS
  Although the risk of late fetal death is greatly increased in fetuses that are extremely small for gestational age the risk is strongly modified by underlying determinants-for example, there is a lower risk of late fetal death in a small for gestational age fetus if the mother is of short stature, has a twin pregnancy, or has hypertension.
authors.affiliation: Department of Medical Epidemiology, Karolinska Institute, S-171 77 Stockholm, Sweden. sven.cnattingius@epic.mep.ki.se
authors.forename: S
authors.initials: S
authors.lastname: Cnattingius
authors.forename: B
authors.initials: B
authors.lastname: Haglund
authors.forename: M S
authors.initials: MS
authors.lastname: Kramer
mesh_terms: D000293:Adolescent; D000328:Adult; D001724:Birth Weight; D001827:Body Height; D015331:Cohort Studies; D005260:Female; D005313:Fetal Death / Q000453:epidemiology*; D006801:Humans; D007236:Infant, Small for Gestational Age; D008423:Maternal Age; D011225:Pre-Eclampsia / Q000150:complications / Q000453:epidemiology; D011247:Pregnancy; D012307:Risk Factors; D012907:Smoking / Q000009:adverse effects / Q000453:epidemiology; D015996:Survival Rate; D013548:Sweden / Q000453:epidemiology