title: Estimated weight centile as a predictor of perinatal outcome in small-for-gestational-age pregnancies with normal fetal and maternal Doppler indices.
abstract: OBJECTIVE
  To evaluate the risk of adverse perinatal outcome according to estimated fetal weight (EFW) in a cohort of term small-for-gestational-age (SGA) pregnancies with normal umbilical, fetal middle cerebral and maternal uterine artery Doppler indices.
  
  
  METHODS
  A cohort of 132 term SGA fetuses with normal umbilical artery pulsatility index (PI), mean uterine artery PI and cerebroplacental ratio was compared to a control group of 132 appropriate-for-gestational-age babies, matched by gestational age at delivery. The capacity of the EFW percentile to predict Cesarean delivery, Cesarean delivery for non-reassuring fetal status (NRFS), neonatal acidosis and days of neonatal hospitalization was analyzed.
  
  
  RESULTS
  As a whole, SGA fetuses with normal Doppler findings did not show a statistically significant difference for intrapartum Cesarean delivery (22.0 vs. 15.9%; P = 0.21) and neonatal acidosis (3.3 vs. 1.5%; P = 0.30), but had significantly higher risk for Cesarean delivery for NRFS (15.9 vs. 5.3%; P < 0.01) and longer neonatal hospitalization (1.39 vs. 0.87 days; P < 0.05) than did controls. SGA fetuses with EFW < 3(rd) centile had a significantly higher incidence of intrapartum Cesarean delivery (30.0 vs. 15.3%; P = 0.04), Cesarean delivery for NRFS (25.0 vs. 8.3%; P < 0.01) and longer neonatal hospitalization (2.0 vs. 0.9 days; P < 0.01) than those with EFW ≥ 3(rd) centile. SGA cases with EFW ≥ 3(rd) centile had perinatal outcomes similar to those of controls with normal EFW.
  
  
  CONCLUSIONS
  Among SGA fetuses with normal placental and cerebral Doppler ultrasound findings, EFW < 3(rd) centile discriminates between those with a higher risk for adverse perinatal outcome and those with outcomes similar to those of normally grown fetuses.
authors.affiliation: Department of Maternal-Fetal Medicine, Institute Clínic of Gynecology, Obstetrics and Neonatology, Hospital Clinic-IDIBAPS, University of Barcelona and Centre for Biomedical Research on Rare Diseases, Barcelona, Spain.
authors.forename: S
authors.initials: S
authors.lastname: Savchev
authors.forename: F
authors.initials: F
authors.lastname: Figueras
authors.forename: R
authors.initials: R
authors.lastname: Cruz-Martinez
authors.forename: M
authors.initials: M
authors.lastname: Illa
authors.forename: F
authors.initials: F
authors.lastname: Botet
authors.forename: E
authors.initials: E
authors.lastname: Gratacos
mesh_terms: D002585:Cesarean Section / Q000706:statistics & numerical data; D015331:Cohort Studies; D005260:Female; D005317:Fetal Growth Retardation / Q000000981:diagnostic imaging* / Q000401:mortality; D020567:Fetal Weight; D006760:Hospitalization; D006801:Humans; D007231:Infant, Newborn; D007236:Infant, Small for Gestational Age; D007751:Labor, Induced / Q000706:statistics & numerical data; D011237:Predictive Value of Tests; D011247:Pregnancy; D011256:Pregnancy Outcome; D011263:Pregnancy Trimester, Third; D012189:Retrospective Studies; D018608:Ultrasonography, Doppler; D016216:Ultrasonography, Prenatal / Q000379:methods*