Second-trimester fetal growth and the risk of poor obstetric and neonatal outcomes.
OBJECTIVE
To compare outcomes of fetuses with an estimated fetal weight (EFW) < 25(th) percentile in the second trimester to those in fetuses with EFW >or= 25(th) percentile in the second trimester.


METHODS
We compared outcomes of 252 pregnancies with an EFW < 25(th) percentile at 18-24 weeks' gestation with those of 265 controls. All pregnancies had early dating by ultrasonography. We excluded fetuses with aneuploidy, major malformations, second-trimester rupture of membranes, and multiple pregnancies.


RESULTS
Second-trimester EFW < 25(th) percentile was significantly associated with higher rates of fetal or neonatal death, third-trimester small for gestational age (SGA), Doppler abnormalities, indicated preterm birth, gestational hypertension or pre-eclampsia before labor, lower birth weight, birth weight < 10(th) percentile, birth weight < 5(th) percentile, and admission to the neonatal intensive care unit. Many of these associations remained even after excluding patients with oligohydramnios, fetal echogenic bowel, and growth asymmetry.


CONCLUSIONS
Second-trimester SGA, as defined by an EFW < 25(th) percentile using current growth curves, is associated with poor obstetric and neonatal outcomes. Increased surveillance of such pregnancies may be necessary.
Fox
N S
NS
Department of Obstetrics and Gynecology, Weill Cornell Medical College, New York, NY, USA. naf9015@med.cornell.edu
Huang
M
M
Chasen
S T
ST
D000328:Adult; D001724:Birth Weight; D016022:Case-Control Studies; D005260:Female; D047109:Fetal Development; D020567:Fetal Weight; D005865:Gestational Age; D006801:Humans; D046110:Hypertension, Pregnancy-Induced / Q000453:epidemiology; D007231:Infant, Newborn; D007234:Infant, Premature; D007236:Infant, Small for Gestational Age; D008297:Male; D009518:New York / Q000453:epidemiology; D011225:Pre-Eclampsia / Q000453:epidemiology; D011247:Pregnancy; D011256:Pregnancy Outcome / Q000453:epidemiology; D011262:Pregnancy Trimester, Second; D012307:Risk Factors; D016216:Ultrasonography, Prenatal