title: Effects of antenatal recognition and follow-up on perinatal outcomes in small-for-gestational age infants delivered after 36 weeks.
abstract: OBJECTIVE
  To compare perinatal outcomes of late small-for-gestational age (SGA, birthweight <10th percentile) infants, according to antenatal recognition.
  
  
  METHODS
  Retrospective study.
  
  
  METHODS
  Tertiary referral center.
  
  
  METHODS
  All singleton pregnancies with SGA (birthweight <10th percentile) infants born ≥36 weeks' gestation from January 2007 to April 2009.
  
  
  METHODS
  Chart review of 771 pregnancies. SGA infants identified prior to delivery (group A) were compared with those not identified (group B).
  
  
  METHODS
  Mode of delivery, perinatal complications, admission to neonatal intensive care unit (NICU). In group A, receiver operating characteristic (ROC) analysis and area under the curve (AUC) of antenatal tests to predict NICU admission were calculated.
  
  
  RESULTS
  In 17% of infants, SGA was recognized before birth (group A), whereas in 83% it was recognized only at birth (group B). Infants with the most severe degree of SGA (birthweight <3rd percentile) were more frequently diagnosed antenatally (30%). Admission to NICU (14 vs. 3%, p < 0.001) and cesarean delivery (42 vs. 26%; p < 0.001) were more likely in group A. Adverse outcomes related to hypoxia were all observed in group B, but the difference was not significant. In antenatally detected fetuses a combination of fetal abdominal circumference, umbilical artery pulsatility index and middle cerebral artery pulsatility index z-scores was useful for prediction of NICU admission (AUC = 0.94).
  
  
  CONCLUSIONS
  Antenatal recognition of late SGA may improve perinatal outcomes. However, admission to neonatal intensive care and cesarean delivery were more frequent among SGA infants recognized antenatally.
authors.affiliation: Maternal-Fetal Medicine Unit, University of Brescia, Brescia, Italy.
authors.forename: Nicola
authors.initials: N
authors.lastname: Fratelli
authors.forename: Adriana
authors.initials: A
authors.lastname: Valcamonico
authors.forename: Federico
authors.initials: F
authors.lastname: Prefumo
authors.forename: Giorgio
authors.initials: G
authors.lastname: Pagani
authors.forename: Tiziana
authors.initials: T
authors.lastname: Guarneri
authors.forename: Tiziana
authors.initials: T
authors.lastname: Frusca
mesh_terms: D000005:Abdomen / Q000196:embryology; D002585:Cesarean Section / Q000706:statistics & numerical data; D005260:Female; D005317:Fetal Growth Retardation / Q000175:diagnosis; D006801:Humans; D007231:Infant, Newborn; D007236:Infant, Small for Gestational Age; D007363:Intensive Care Units, Neonatal; D020768:Middle Cerebral Artery / Q000502:physiology; D011247:Pregnancy; D011256:Pregnancy Outcome; D011673:Pulsatile Flow; D012372:ROC Curve; D014469:Umbilical Arteries / Q000502:physiology